FREQUENCY OF TYPES OF MALIGNANCIES ON THORACOSCOPIC PLEURAL BIOPSY IN PATIENTS WITH MALIGNANT PLEURAL EFFUSION

Background: Malignant pleural effusion (MPE) is defined by the presence of cancerous cells in the pleural fluid. The malignancies most commonly metastasizing to pleura are Lung cancer, Breast cancer, Lymphoma, Ovarian cancer and Gastric Cancer. Pleural biopsy is required for the diagnosis of malignant pleural disease. Medical Thoracoscopy is now increasingly used for the diagnosis of MPEs. The current study has been designed to check the frequency of different types of malignancies on pleural biopsies taken via Medical Thoracoscopy. Objectives: To Study the frequency of different types of malignancies on pleural biopsies taken via Medical Thoracoscopy. Methods: This study was carried out at the Department of Pulmonology, Shaikh Zayed FPGMI, Lahore, from January 1, 2020, to December 31, 2022. Retrospective analysis of 166 medical thoracoscopy procedures performed on the patients with malignant pleural effusion. Results: A total of 166 participants were included in this study, having a mean age of ± SD of 56.6 ± 14.8 years (range: 15-97). Among them 70 (42.2%) were males while 96 (57.8%) were females. The most frequent malignancy diagnosed on pleural biopsy was adenocarcinoma (57.8%) followed by poorly differentiated metastatic carcinoma (22.3%). Other histological types diagnosed on pleural biopsy included lymphoma (4.8%), squamous cell carcinoma (4.8%), small cell carcinoma (4.2%), and metastatic renal cell carcinoma (3.0%). The lung (43.4%) was the most common primary site of malignancy presenting with pleural metastasis; other sites included breast (15.1%), ovary (7.2%) and kidneys (3.0%). Eight study participants had hematological malignancies while in 18.1% primary site remained unknown and further workup was advised. Conclusion: Adenocarcinoma emerged as the most frequently diagnosed type of malignancy on thoracoscopic pleural biopsy and lung (43.4%) was the most frequent primary site of malignancy presenting with pleural metastasis.