Leslie W K, Kinasewitz G T
Department of Medicine, Louisiana State University Medical Center, Shreveport 71130-39.
Chest. 1988 Sep;94(3):603-8. doi: 10.1378/chest.94.3.603.
To determine if patients with nonspecific pleuritis could be clinically distinguished from those with malignant or granulomatous pleural disease, the medical records and chest roentgenograms of all patients who had a closed needle biopsy of the pleura during a five-year period from January 1979 to December 1983 were reviewed. A total of 119 patients were categorized based upon their ultimate diagnosis as having malignant (n = 41), granulomatous (n = 25), or nonspecific pleuritis (n = 53). Weight loss, fever greater than 38 degrees, a positive PPD, a pleural fluid lymphocytosis of greater than 95 percent, and an effusion which occupied more than half a hemithorax were significantly more common in the patients with malignant or granulomatous disease. Based on these results, a conservative approach is recommended for the patient with an initial biopsy which reveals only nonspecific pleuritis who has none of the criteria, but an aggressive diagnostic work-up in the individual with two or more criteria is advocated.
