Key result
VATS successfully diagnoses tuberculous pleuritis presenting as suspected pleural malignancy.
Why the study?
Tuberculous pleuritis may closely mimic pleural malignancy when presenting with loculated effusion, pleural thickening, or chest wall involvement, creating a diagnostic challenge amplified in resource-limited settings.
Case Report (n=1)
Thoracoscopic pleural biopsy via VATS is a highly valuable diagnostic tool for differentiating tuberculous pleuritis from pleural malignancy, especially in resource-limited settings where non-invasive tests are inconclusive.
Answers are grounded in this paper and cite their sources.
VATS biopsy may facilitate diagnosis of tuberculous pleuritis mimicking malignancy after inconclusive thoracentesis; hypothesis-generating and leaves open need for prospective validation.
Tuberculous pleuritis is a common form of extrapulmonary tuberculosis that may closely mimic pleural malignancy, particularly when associated with loculated effusion, pleural thickening, or chest wall involvement. This diagnostic challenge is amplified in resource-limited settings. We report a 41-year-old male with a 30 pack-year smoking history who presented with a two-month history of pleuritic chest pain, dyspnea, night sweats, and significant weight loss. Imaging revealed a large loculated right-sided pleural effusion with diffuse pleural thickening and associated rib destruction, raising strong suspicion for pleural malignancy. Thoracentesis demonstrated a lymphocyte-predominant exudative effusion. Due to limited diagnostic resources, advanced microbiological investigations were unavailable. The patient underwent video-assisted thoracoscopic surgery (VATS), which revealed diffusely thickened pleura with multiple whitish plaques. Histopathological examination revealed caseating granulomatous inflammation consistent with tuberculous pleuritis. The patient responded well to anti-tuberculous therapy. Tuberculous pleuritis can mimic pleural malignancy, particularly in the presence of chest wall involvement. Thoracoscopic pleural biopsy remains a highly valuable diagnostic tool in cases where non-invasive investigations are inconclusive or unavailable.
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Rshrash et al. (2026) conducted a case report in Tuberculous pleuritis (n=1). Video-assisted thoracoscopic surgery (VATS) was evaluated on Diagnosis of tuberculous pleuritis. Video-assisted thoracoscopic surgery (VATS) successfully diagnosed tuberculous pleuritis in a patient presenting with clinical and imaging features mimicking pleural malignancy.
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