[Diagnosis of tuberculous pleurisy with special reference to thoracoscopic biopsy findings]

132 tuberculous pleurisies were diagnosed between 578 thoracoscopies from 1970 to June 1985. A histological confirmation of diagnosis was achieved in 51.5% of the specific pleurisies, whereas in 15.2% typical endoscopic findings were present. 33.3% of the diseases were diagnosed based on the clinical and roentgenological appearance or ex juvantibus after antituberculous therapy. An increase of histologically negative biopsies was noted after a pretreatment of more than 4 weeks before thoracoscopy. This fact is interpreted as caused by an increasing exudation of fibrin, which permits to perform a probe-excision only without optical control. If there were macroscopic findings suspicious for pleural tuberculosis a histological confirmation succeeded in 68.8%. In cases with the uncharacteristic picture of "fibrinous pleurisies" the diagnosis of tuberculosis was confirmed morphologically in 33.9%. These investigations support the diagnostic value of the macroscopic criteria in case of pleural tuberculosis which are reported by Sattler.