What does this research mean for the field?

Medical thoracoscopy achieves a 96% diagnostic yield in undiagnosed exudative pleural effusions, predominantly identifying malignancy and tuberculosis, and pleural fluid ADA levels are significantly higher in tuberculous versus malignant effusions. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the diagnostic yield of medical thoracoscopy and examine pleural fluid adenosine deaminase levels in patients with undiagnosed exudative pleural effusion.

August 28, 2026Monaldi Archives for Chest DiseaseOpen Access

Diagnostic yield of thoracoscopic pleural biopsy in undiagnosed exudative pleural effusion and comparative analysis of pleural fluid adenosine deaminase levels

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To evaluate the diagnostic yield of medical thoracoscopy and examine pleural fluid adenosine deaminase levels in patients with undiagnosed exudative pleural effusion.
Prospective, single-center observational study of 150 consecutive adults (N=150) in north India presenting with undiagnosed exudative pleural effusion after negative GeneXpert tests and negative cytology on at least two samples.
All participants underwent single-port medical thoracoscopy under conscious sedation to obtain 3–6 targeted pleural biopsy samples for histopathology and CBNAAT analysis.
Thoracoscopic pleural biopsy achieved an overall diagnostic yield of 96% (144/150), identifying malignancy in 69.3% (104/150; predominantly metastatic adenocarcinoma, 88/104) and tuberculosis in 26.7% (40/150).
Pleural fluid adenosine deaminase was significantly higher in tuberculous effusions than in malignant effusions (40.17 vs. 20.11 IU/L; p<0.001).
Tissue CBNAAT positivity was 22.5% (9/40) in biopsy-proven tuberculous effusions, and no procedure-related mortality occurred.

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Implication

Prospective observational study reveals a 96% diagnostic yield for medical thoracoscopy in undiagnosed exudative effusion, indicating its high utility in separating malignancy from tuberculosis.

Cite This Study

Sharma et al. (2026) studied this question.

synapsesocial.com/papers/6a9145ead15324a1df3a9167 https://doi.org/10.4081/monaldi.2026.3910

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Implication

Prospective observational study reveals a 96% diagnostic yield for medical thoracoscopy in undiagnosed exudative effusion, indicating its high utility in separating malignancy from tuberculosis.

Diagnostic yield of thoracoscopic pleural biopsy in undiagnosed exudative pleural effusion and comparative analysis of pleural fluid adenosine deaminase levels

Key Points

Discussion

Implication

Cite This Study

Diagnostic yield of thoracoscopic pleural biopsy in undiagnosed exudative pleural effusion and comparative analysis of pleural fluid adenosine deaminase levels

Key Points

Discussion

Implication

Cite This Study

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