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Chest clinic
Images in thorax
Use of cryobiopsy during pleuroscopy for diagnosis of sarcomatoid malignant mesothelioma
  1. Hiang-Ping Chan1,2,
  2. Mei-Fong Liew1,2,
  3. Ju-Ee Seet3,
  4. Pyng Lee1,2
  1. 1Divison of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System, Singapore, Singapore
  2. 2Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  3. 3Department of Pathology, National University Health System, Singapore, Singapore
  1. Correspondence to Dr Hiang-Ping Chan, Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System, 1E Kent Ridge Rd, Singapore 119228, Singapore; chp.chan{at}gmail.com

https://doi.org/10.1136/thoraxjnl-2016-208994

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    A 74-year-old man presented with cough of 3 weeks' duration. Chest X-ray showed a large left-sided pleural effusion (figure 1) that was a lymphocytic exudate with normal adenosine deaminase level, and negative bacterial and mycobacterial cultures. Flexi-rigid pleuroscopy (LTF 160, Olympus, Japan) revealed candle-wax fibrotic parietal pleura (figure 2), which was sampled using the flexible forceps (FB-55CD-1, Olympus, Japan) with cusps measuring 2.4 mm when fully open, and a cryoprobe of 2.4 mm in diameter (20416-032, Erbokryo CA, Erbe, Germany). The cryoprobe was directed to the target area and 4-second freeze time was applied. The pleuroscope and cryoprobe with the pleural specimen attached …

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    Footnotes

    • Contributors H-PC and PL were involved in the pleuroscopic biopsy and writing up of the manuscript. M-FL was involved with the radiology and the writing up of the manuscript. J-ES was involved in analysis of the histology and writing up of the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.