Abstract
The role of thoracoscopy in determining pleural effusion due to tuberculosis was evaluated. The evaluation was conducted on 9 cases of pathologically proven tuberculous pleural lesions. Clinical and laboratory tests suggested tuberculous pleuritis in 7 out of the 9 cases. The thoracoscopic findings in those cases revealed diffuse small white nodules on their parietal and visceral pleura, and these nodules were found to contain tuberculous granulomas pathologically. For the other two cases determined as tuberculous empyema, clinical and laboratory examinations could not suggest any specific pathogen. Thoracoscopy revealed multilocular fibropurulent lesions and white purulent tunica. Pleural lesions sampled by thoracoscopic biopsy did not present any tuberculous granulomas pathologically. Although it is thought that the thoracoscopic findings of diffuse small white nodules on the pleura are specific to tuberculous pleuritis, it is difficult to detect these lesions by thoracoscopy in tuberculous empyema. In conclusion, thracoscopic evaluation is very useful for the diagnosis of tuberculous pleuritis, but may have less value for tuberculous empyema.
