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Updated: Aug 5, 2025

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Diagnosis and outcome of patients with idiopathic pleural effusions
A Vázquez1, M Simó2, O Persiva3
1Departments of Internal Medicine, University Autonomous of Barcelona, Universitat Autònoma de Barcelona, University Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain.
Introduction:
Long-term follow-up course for patients with idiopathic pleural effusions has not been established.
Methods:
From October 2013 to June 2021 all patients with idiopathic effusion were prospectively followed up with clinical examination and imaging at 1, 3, 6 and every 6 months for a minimum of 1 year.
Results:
Twenty-nine patients were diagnosed with idiopathic effusion and followed up. Mesothelioma was detected during the follow-up in two patients at 7 and 18 months, one of whom had blood-tinged pleural fluid and the other reported a 10% weight loss. Mesothelioma was not diagnosed in any of the patients with effusion covering less than two thirds of the hemithorax, and without constitutional symptoms or a blood-tinged fluid appearance. Most of the effusions resolved or showed a clear improvement in the first six months.
Conclusion:
Patients without weight loss and with small, non-hematic effusions, may benefit from conservative treatment and clinical-radiological follow-up.
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