Application of medical thoracoscopy combined with probe-based confocal laser endomicroscopy in diagnosing malignant pleural lesions:a report of 2 cases
YE Shenglan
ZHU Shan
YUAN Mingli
SONG Cheng
HU Yi
NI Jixiang
Abstract：Objective To explore the clinical value of probe-based confocal laser endomicroscopy(pCLE)as an ad-junct to medical thoracoscopy in the diagnosis of pleural diseases,and to provide evidence for the precise diagnosis of early pleural lesions.Methods The diagnostic and therapeutic processes of two patients with pleural effusion of unknown etiol-ogy accompanied by abnormally elevated tumor markers were retrospectively analyzed.Both patients first underwent con-ventional medical thoracoscopy.Subsequently,pCLE was introduced through the working channel of the medical thoraco-scope to perform real-time,in vivo histological-level observation of suspicious pleural areas.Targeted pleural cytological examination and biopsy were then performed at sites showing abnormalities on pCLE.Results Conventional medical tho-racoscopy revealed no obvious pleural abnormalities in either patient,and appropriate biopsy sites could not be clearly identified.In contrast,pCLE detected clusters of atypical cells in both cases.In Case 1,intraoperative pleural effusion cy-tology revealed clusters of atypical glandular epithelial cells.In Case 2,pleural biopsy guided by pCLE demonstrated a ma-lignant epithelial tumor.Ultimately,both patients were pathologically confirmed to have lung adenocarcinoma.The histo-pathological findings were highly consistent with the intraoperative pCLE observations in both cases.Conclusions The pCLE enables real-time,in vivo histological-level visualization of the pleura and can effectively identify early,subtle pleu-ral lesions.It provides precise targeting guidance for pleural biopsy during medical thoracoscopy,compensates for the diag-nostic limitations of conventional medical thoracoscopy,and has important clinical value in improving the diagnostic rate of early pleural diseases.
Keywords：probe-based confocal laser endomicroscopymedical thoracoscopyearly pleural lesionsunexplained pleural effusionlung adenocarcinoma
Publication Date：2026-01-25
Online Publishing Date：2026-03-05(First online date of this platform, not the publication date of the document)
Pages：4( 100-103 )