[A comparison of the result of aspiration, needle-biopsy, pleuroscopy and thoracotomy in the diagnosis of chronic pleurisy (author's transl)].

A series of 60 diagnostic pleuroscopies was carried out in cases of isolated chronic pleurisy, or pleurisy accompanied with pleural and parenchymatous lesions. The following diagnoses were obtained : 23 non-specific chronic inflammations, 1 purulent pleurisy, 1 rheumatoid pleurisy, 25 neoplasms and 10 tuberculosis. In all cases, pleural aspiration, with bacteriology and cytotology of the fluid, as well as pleural needle-biopsy with the Abrams needle, were carried out before, with negative results in 53 cases and doubtful results in 7 cases. Later, 14 thoracotomies were carried out, either for diagnosis or for treatment (pleuro-pulmonary decortication). The diagnosis obtained by pleuroscopy was confirmed in 10 cases (5 chronic inflammations, 1 purulent pleurisy, 1 mesothelioma, 3 tuberculosis), but not confirmed in 4 cases : simple chronic inflammations related in reality to 3 neoplasms and a diagnosis of tuberculosis also due to a neoplasm. Overall, pleuroscopy allowed the diagnosis of 55 chronic pleurisies out of 60 (92%), confirmed by the progress of the disease, or later thoracotomy (10 cases). The reliability of this procedure is certain when the histology of the neoplasm or the specific condition is obtained (37 cases), but the diagnosis of chronic non-specific inflammation remains a provisional diagnosis. Exploratory thoracotomy retained its indication in this case and allowed the diagnosis to be corrected in 4 cases out of 14.