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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 …