• Shu-juan Jiang, Xiao-yan Mu, Song Zhang, Li-li Su, and Wei-xia Ma.
• Department of Pulmonary Medicine, Provincial Hospital affiliated to Shandong University, Jinan 250021, China (Email:shujuan-jiang@163.com).
• Zhonghua Jie He He Hu Xi Za Zhi. 2013 May 1;36(5):337-40.

ObjectiveTo explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy.MethodsA retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy.ResultsThe endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed.ConclusionMedical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

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