Idiopathic pleuritis: Truth or myth?

Objective: To determine the presence or not of idiopathic pleuritis in patients that underwent medical thoracoscopy(MT) Materials and methods: Retrospective study of 750 patients (1998-2011) that underwent MT under conscious and local sedation. Assessment of clinicopathological status/results and clinical follow up in the thoracic outpatients clinic. Results: Thirty two patients were excluded from the group of patients with undiagnosed pleural effusion (histology report:systemic disease or parapneumonic effusion).152/770 patients(20.2%)were classified as idiopathic pleuritis (sinister and any other underlying pathology was excluded) and underwent long term surveillance. Mean surveillance was 4.1 years(2months–9years). During that time 2/152 was diagnosed with lung cancer. 3/152 presented pleural effusion recurrence without any signs of malignancy/systemic disease and underwent talc pleurodesis. Conclusions: Undiagnosed pleural effusions constitute a large group among the pleural effusion patients. This group is associated with favourable patient outcome and encouraging prognosis especially when the diagnosis is set by MT under conscious sedation.