Diagnosis of malignant pleural disease: Ultrasound as “a detective probe”

Abstract Background Malignant pleural mesothelioma (MPM) is an invasive, aggressive pleural tumor with a predominantly local spread. The objective of this study was to assess thoracic ultrasound (TUS) as an imaging modality with high sensitivity for the identification of malignant pleural involvemen...

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Main Authors: Gaetana Messina, Mary Bove, Giovanni Natale, Vincenzo Di Filippo, Giorgia Opromolla, Anna Rainone, Beatrice Leonardi, Mario Martone, Alfonso Fiorelli, Giovanni Vicidomini, Mario Santini, Andrea Ronchi, Eva Massimilla, Carminia Maria Della Corte, Mario Pirozzi, Marianna Caterino, Fortunato Ciardiello, Morena Fasano
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Thoracic Cancer
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Online Access:https://doi.org/10.1111/1759-7714.14735
Description
Summary:Abstract Background Malignant pleural mesothelioma (MPM) is an invasive, aggressive pleural tumor with a predominantly local spread. The objective of this study was to assess thoracic ultrasound (TUS) as an imaging modality with high sensitivity for the identification of malignant pleural involvement and in order to guide pleural biopsies. Methods In this retrospective single‐center study between January 2018 and June 2022, 51 consecutive patients with impassable circumferential pleural thickening underwent TUS at the Thoracic Surgery Unit of the Vanvitelli University of Naples. Pleural biopsies were performed, and then large and multiple samples were sent to the pathological anatomy for histological examination. Results In all patients who underwent ultrasound examination, we chose the optimal point of entry to perform pleural biopsies and selected the areas of greater thickening without pleural effusion. No patient had any complications. No drainage tubes were placed after the pleural biopsies and no pneumothorax was present during the following days of hospitalization. The patients were discharged on the second postoperative day. Conclusion With TUS the precise pleural thickening localization, local infiltration, mass extent, its nature (solid, cystic or complex) and ultrasound features can be easily defined. Furthermore, ultrasound is more economical than computed tomography and avoids the risks associated with radiation. Thoracic ultrasound is an important component of the diagnostic procedure in detecting a safe entry site for biopsies of MPMs.
ISSN:1759-7706
1759-7714