TY - JOUR T1 - To the Editor: Blind needle biopsy of the pleura: why not? JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW SP - 120 LP - 122 DO - 10.1183/09059180.00000711 VL - 20 IS - 120 AU - K. Psathakis AU - V. Skouras Y1 - 2011/06/01 UR - http://err.ersjournals.com/content/20/120/120.abstract N2 - To the Editor:We read with great interest the excellent review by Janssen [1] in the September issue of the European Respiratory Review, where the author highlights the position of thoracoscopy in the current diagnostic armamentarium of pneumonology and nicely concentrates the up-to-date knowledge in the field.As a general comment, we would say that thoracoscopy is not a panacea for the diagnosis of pleural effusions; however, the value of blind needle biopsy of the pleura (or closed-pleural biopsy; CPB) may not actually be so limited.Thoracoscopy is essentially the best way to biopsy the pleura. However, not all diseases that affect the pleura can be diagnosed by pleural biopsy, even with the best techniques. The main histological abnormalities of the pleura that demonstrate disease specificity are those associated with malignant and granulomatous disorders, the most frequent representative of the latter disease category being tuberculosis (TB) [2, 3]. Thus, pleural biopsy (and thoracoscopy) can virtually diagnose two main disorders: malignant pleural effusions (MPEs) and TB pleuritis. In the case that the patient does not suffer from either of them, the pathologist will most probably diagnose “nonspecific pleuritis”. Although “not specific”, this diagnosis can exclude malignancy because of the high negative predictive value of thoracoscopy for MPEs [4]. This observation highlights … ER -