Diagnosis of Pleural Mesothelioma by Pleuroscopic Cryobiopsy: Case Report
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Abstract
Introduction: Pleural mesothelioma (PM) is a rare and aggressive malignant neoplasm that originates from the mesothelial surface of the pleura. Cryobiopsy (CB) has been described as a safe and highly effective diagnostic technique for pleural pathology, due to the larger sample size and fewer artifacts.
Case report: A 76-year-old female patient presented with progressive dyspnea and chest pain. Chest imaging revealed a left pleural effusion which was consistent with a lymphocytic exudate with normal adenosine deaminase levels and negative microbiology. Pleuroscopy showed parietal pleura with nodular infiltrates. Samples were obtained using a 1.7 mm diameter cryoprobe. Cryobiopsies revealed epithelioid pleural mesothelioma. Immunohistochemical analysis was positive for calretinin and negative for thyroid transcription factor 1 (TTF1), cytokeratin 7 (CK7), and cytokeratin 20 (CK20).
Discussion: The use of pleural cryobiopsy via pleuroscopy as a diagnostic method has demonstrated superiority compared to the use of forceps. Furthermore, there is limited evidence regarding its use for the diagnosis of pleural mesothelioma. We describe the following successfully performed clinical case, demonstrating the usefulness of pleural cryobiopsy during pleuroscopy in the diagnosis of pleural mesothelioma.
Conclusions: We present a clinical case that illustrates the usefulness of pleural cryobiopsy through pleuroscopy for the diagnosis of pleural mesothelioma, in which large and extensive samples are required to define the anatomopathological diagnosis.
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