Video-assisted thoracoscopic surgery (VATS) successfully diagnosed tuberculous pleuritis in a patient presenting with clinical and imaging features mimicking pleural malignancy.
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.
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.
Rshrash et al. (Wed,) 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.