Successful Diagnostic Confirmation of Malignant Pleural Mesothelioma With Extensive Pleural Adhesions Using Pleural Cryobiopsy Under Local Anaesthesia.

Authors

Shotaro Otaki, Mikito Suzuki, Kaito Yano, Tomohiro Imoto, Reiko Shimizu, Tsunekazu Hishima, Kazuo Nakagawa

Published in

Respirology case reports. Volume 14. Issue 8. Pages e70704. Epub Jul 29, 2026.

Abstract

Local anaesthesia thoracoscopy using flex-rigid thoracoscope is useful for diagnosing pleural lesions, but it is generally not indicated in cases with extensive pleural adhesions. We report a case of malignant pleural mesothelioma (MPM) with extensive pleural adhesions that was safely diagnosed using pleural cryobiopsy under local anaesthesia. A 65-year-old man with a history of asbestos exposure presented with chest pain and significant weight loss. A very small amount of pleural effusion, narrowing of the left lower intercostal spaces on chest computed tomography (CT) and negative lung sliding sign on transthoracic echocardiography (TTE) indicated significant pleural adhesions. Considering the high risk of general anaesthesia, biopsy under minimally invasive local anaesthesia was chosen. Precise localization of the lesions using positron emission tomography-CT and TTE enables making the incision over the tumour. After minimal adhesion dissection, pleural cryobiopsy was performed and a definitive diagnosis of epithelial MPM was made.

PMID:
42534444
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

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