Janssen Julius, Maldonado Fabien, Metintas Muzaffer
Department of Pulmonary Diseases B70, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Vanderbilt-Ingram Cancer Center, Division of Allergy, Pulmonary and Critical Care Medicine, Nashville, Tennessee.
Clin Respir J. 2018 Sep;12(9):2407-2410. doi: 10.1111/crj.12940.
Non-specific pleuritis (NSP) is defined as fibrinous or inflammatory pleuritis which cannot be attributed to a specific benign or malignant etiology. It can be diagnosed in biopsies in up to 30% of cases of exudative pleuritis after thoracoscopy, with a mean of 19.2%. In 66 out of 469 (14.2%) patients in combined series, a malignant pleural disease (mostly mesothelioma) was found during a follow-up of at least 21 months. Most likely, a follow-up time of 12 months is sufficient, although the current routine is a follow-up of 2 years. Because of a benign course in 85% of patients with NSP, a repeated invasive procedure after thoracoscopy is only indicated in a limited group of patients. The most important indications for a repeated pleural biopsy are persistent chest pain, recurrent pleural effusion, radiologic findings suggestive for malignant pleural disease.
非特异性胸膜炎（NSP）被定义为无法归因于特定良性或恶性病因的纤维蛋白性或炎症性胸膜炎。在胸腔镜检查后的渗出性胸膜炎病例中，高达30%的病例在活检中可诊断为此病，平均诊断率为19.2%。在469例患者的综合系列研究中，66例（14.2%）在至少21个月的随访期间发现患有恶性胸膜疾病（主要是间皮瘤）。虽然目前的常规随访时间是2年，但最有可能的是，12个月的随访时间就足够了。由于85%的NSP患者病程呈良性，胸腔镜检查后仅在有限的一组患者中进行重复侵入性检查。重复胸膜活检的最重要指征是持续性胸痛、复发性胸腔积液、提示恶性胸膜疾病的影像学表现。
