Nonspecific pleuritis: Optimal duration of follow-up

Zachary Depew, Akash Verma, Dennis Wigle, John J. Mullon, Francis C. Nichols, Fabien Maldonado

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background Nonspecific pleuritis (NSP) is a frequent diagnosis after parietal pleural biopsy, but the clinical significance of this finding and need for further follow-up have not been firmly established. Previous reports suggest that 5% to 25% of patients with NSP are subsequently diagnosed with pleural malignancy. Methods Our pathology database was queried for patients with histologic evidence of NSP from January 01, 2001, to December 31, 2012 (n = 413). Patients with less than 1 year of follow-up after biopsy, diagnosis of empyema, tuberculous pleuritis, active systemic connective tissue disease or vasculitis, or active malignancy were excluded (n = 327). The remaining patients were included and their medical records were reviewed. Results Eighty-six patients were included. Mean follow up was 1,824 ± 1,032 days (range, 409 to 4,599 days). Three of the 86 patients with NSP (3.5%) were subsequently diagnosed with pleural malignancy. All 3 patients were found to have mesothelioma with a mean time from biopsies to diagnosis of 205 ± 126 days (range, 64 to 306 days). Twenty-two of 86 patients (25.5%) had a possible identifiable cause of pleural inflammation (benign disease). After exclusion of these 22 patients, the incidence of malignancy was 3 of 64 (4.7%). Conclusions The incidence of subsequent pleural malignancy (mesothelioma) among patients found to have NSP based on pleural biopsy was 3.5%. Occult mesothelioma in patients with NSP will most likely be diagnosed within 1 year of the initial pleural biopsy; therefore, these patients should be followed for a minimum of 1 year to allow for timely detection of occult pleural malignancy.

Original languageEnglish
Pages (from-to)1867-1871
Number of pages5
JournalAnnals of Thoracic Surgery
Volume97
Issue number6
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Pleurisy
Mesothelioma
Biopsy
Neoplasms
Tuberculous Empyema
Connective Tissue Diseases
Incidence
Vasculitis
Medical Records

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Depew, Z., Verma, A., Wigle, D., Mullon, J. J., Nichols, F. C., & Maldonado, F. (2014). Nonspecific pleuritis: Optimal duration of follow-up. Annals of Thoracic Surgery, 97(6), 1867-1871. https://doi.org/10.1016/j.athoracsur.2014.01.057

Nonspecific pleuritis : Optimal duration of follow-up. / Depew, Zachary; Verma, Akash; Wigle, Dennis; Mullon, John J.; Nichols, Francis C.; Maldonado, Fabien.

In: Annals of Thoracic Surgery, Vol. 97, No. 6, 2014, p. 1867-1871.

Research output: Contribution to journalArticle

Depew, Z, Verma, A, Wigle, D, Mullon, JJ, Nichols, FC & Maldonado, F 2014, 'Nonspecific pleuritis: Optimal duration of follow-up', Annals of Thoracic Surgery, vol. 97, no. 6, pp. 1867-1871. https://doi.org/10.1016/j.athoracsur.2014.01.057
Depew, Zachary ; Verma, Akash ; Wigle, Dennis ; Mullon, John J. ; Nichols, Francis C. ; Maldonado, Fabien. / Nonspecific pleuritis : Optimal duration of follow-up. In: Annals of Thoracic Surgery. 2014 ; Vol. 97, No. 6. pp. 1867-1871.
@article{95fd787e8b0847658263ccd59332f762,
title = "Nonspecific pleuritis: Optimal duration of follow-up",
abstract = "Background Nonspecific pleuritis (NSP) is a frequent diagnosis after parietal pleural biopsy, but the clinical significance of this finding and need for further follow-up have not been firmly established. Previous reports suggest that 5{\%} to 25{\%} of patients with NSP are subsequently diagnosed with pleural malignancy. Methods Our pathology database was queried for patients with histologic evidence of NSP from January 01, 2001, to December 31, 2012 (n = 413). Patients with less than 1 year of follow-up after biopsy, diagnosis of empyema, tuberculous pleuritis, active systemic connective tissue disease or vasculitis, or active malignancy were excluded (n = 327). The remaining patients were included and their medical records were reviewed. Results Eighty-six patients were included. Mean follow up was 1,824 ± 1,032 days (range, 409 to 4,599 days). Three of the 86 patients with NSP (3.5{\%}) were subsequently diagnosed with pleural malignancy. All 3 patients were found to have mesothelioma with a mean time from biopsies to diagnosis of 205 ± 126 days (range, 64 to 306 days). Twenty-two of 86 patients (25.5{\%}) had a possible identifiable cause of pleural inflammation (benign disease). After exclusion of these 22 patients, the incidence of malignancy was 3 of 64 (4.7{\%}). Conclusions The incidence of subsequent pleural malignancy (mesothelioma) among patients found to have NSP based on pleural biopsy was 3.5{\%}. Occult mesothelioma in patients with NSP will most likely be diagnosed within 1 year of the initial pleural biopsy; therefore, these patients should be followed for a minimum of 1 year to allow for timely detection of occult pleural malignancy.",
author = "Zachary Depew and Akash Verma and Dennis Wigle and Mullon, {John J.} and Nichols, {Francis C.} and Fabien Maldonado",
year = "2014",
doi = "10.1016/j.athoracsur.2014.01.057",
language = "English",
volume = "97",
pages = "1867--1871",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Nonspecific pleuritis

T2 - Optimal duration of follow-up

AU - Depew, Zachary

AU - Verma, Akash

AU - Wigle, Dennis

AU - Mullon, John J.

AU - Nichols, Francis C.

AU - Maldonado, Fabien

PY - 2014

Y1 - 2014

N2 - Background Nonspecific pleuritis (NSP) is a frequent diagnosis after parietal pleural biopsy, but the clinical significance of this finding and need for further follow-up have not been firmly established. Previous reports suggest that 5% to 25% of patients with NSP are subsequently diagnosed with pleural malignancy. Methods Our pathology database was queried for patients with histologic evidence of NSP from January 01, 2001, to December 31, 2012 (n = 413). Patients with less than 1 year of follow-up after biopsy, diagnosis of empyema, tuberculous pleuritis, active systemic connective tissue disease or vasculitis, or active malignancy were excluded (n = 327). The remaining patients were included and their medical records were reviewed. Results Eighty-six patients were included. Mean follow up was 1,824 ± 1,032 days (range, 409 to 4,599 days). Three of the 86 patients with NSP (3.5%) were subsequently diagnosed with pleural malignancy. All 3 patients were found to have mesothelioma with a mean time from biopsies to diagnosis of 205 ± 126 days (range, 64 to 306 days). Twenty-two of 86 patients (25.5%) had a possible identifiable cause of pleural inflammation (benign disease). After exclusion of these 22 patients, the incidence of malignancy was 3 of 64 (4.7%). Conclusions The incidence of subsequent pleural malignancy (mesothelioma) among patients found to have NSP based on pleural biopsy was 3.5%. Occult mesothelioma in patients with NSP will most likely be diagnosed within 1 year of the initial pleural biopsy; therefore, these patients should be followed for a minimum of 1 year to allow for timely detection of occult pleural malignancy.

AB - Background Nonspecific pleuritis (NSP) is a frequent diagnosis after parietal pleural biopsy, but the clinical significance of this finding and need for further follow-up have not been firmly established. Previous reports suggest that 5% to 25% of patients with NSP are subsequently diagnosed with pleural malignancy. Methods Our pathology database was queried for patients with histologic evidence of NSP from January 01, 2001, to December 31, 2012 (n = 413). Patients with less than 1 year of follow-up after biopsy, diagnosis of empyema, tuberculous pleuritis, active systemic connective tissue disease or vasculitis, or active malignancy were excluded (n = 327). The remaining patients were included and their medical records were reviewed. Results Eighty-six patients were included. Mean follow up was 1,824 ± 1,032 days (range, 409 to 4,599 days). Three of the 86 patients with NSP (3.5%) were subsequently diagnosed with pleural malignancy. All 3 patients were found to have mesothelioma with a mean time from biopsies to diagnosis of 205 ± 126 days (range, 64 to 306 days). Twenty-two of 86 patients (25.5%) had a possible identifiable cause of pleural inflammation (benign disease). After exclusion of these 22 patients, the incidence of malignancy was 3 of 64 (4.7%). Conclusions The incidence of subsequent pleural malignancy (mesothelioma) among patients found to have NSP based on pleural biopsy was 3.5%. Occult mesothelioma in patients with NSP will most likely be diagnosed within 1 year of the initial pleural biopsy; therefore, these patients should be followed for a minimum of 1 year to allow for timely detection of occult pleural malignancy.

UR - http://www.scopus.com/inward/record.url?scp=84901760358&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901760358&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2014.01.057

DO - 10.1016/j.athoracsur.2014.01.057

M3 - Article

C2 - 24681036

AN - SCOPUS:84901760358

VL - 97

SP - 1867

EP - 1871

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 6

ER -