Background: Rigid thoracoscope is considered the gold standard procedure for diagnosis of pleural malignancies, but sometimes forceps biopsies are insufficient for diagnosis, the main aim of this study is to assess the diagnostic yield of pleural cryobiopsy and the safety of the procedure in cases with undiagnosed exudative pleural effusion.

Methods

The study was a prospective one and was done on 30 patients with an exudative pleural effusion that has not been yet diagnosed by the standard investigations. They underwent thoracoscopic pleural cryobiopsy, 6 of them were excluded as they were proved to be of inflammatory origin as revealed by histopathological results, While the remaining 24 patients with malignant pleural pathology were included in the study.

Results

Histopathological results of cryobiopsy was 100 % diagnostic, the most common result was mesothelioma (70.8%). In (83.3%) of cases there were fat cells in the biopsy reflecting the good depth of cryobiopsies. There were no crush cells in all biopsies reflecting the good quality and preserved tissue of cryobiopsies. As regard the complications there were mild controllable bleeding and post procedural pain that was controlled by simple analgesics.



Conclusions

Thoracoscopic pleural cryobiopsy has a high diagnostic yield with good depth and high quality and it is an effective procedure with mild controllable complications.