The diagnosis of pleural effusions by fiberoptic bronchoscopy and pleuroscopy.

Fiberoptic bronchoscopy was carried out in 28 patients with an undiagnosed pleural effusion. In four patients, the diagnosis was made by this examination. Three patients had bronchial carcinomas, and one had tuberculosis. None of these four patients had roentgenographic evidence of pulmonary infiltrates, atelectasis, or mass lesions. Pleuroscopic examination was performed in 14 patients with the fiberoptic bronchoscope. The diagnosis was made in three. Prior nondiagnostic blind needle biopsy had been carried out in 11 patients and in all three diagnosed by pleuroscopy. Two patients had metastatic carcinoma of the pleural and one tuberculosis. Of 12 patients with effusions and positive Mantoux tests who had no other evidence of tuberculosis, none had clinical evidence of the disease during the period of follow-up. We conclude that bronchoscopic and pleuroscopic examination is of value in the work-up of patients with undiagnosed pleural effusions without roentgenographic evidence of mass lesion or atelectasis.