Anonymous asks, If a patient, on chest CT, has a mass invading the hilum and mediastinum and there is also a pleural effusion, would you be able to simply do a thoracentesis for cytology and forego the bronch?
My take is that a bronchoscopy would not be neccessary, as a positive effusion will both diagnose and stage it as a T4. What do you think?
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Agreed. A thoracentesis is a simple quick way to get diagnosis and staging if you have a malignant effusion.
I agree as well-if the cytology is positive. It may be a paramalignant effusion, so if the cytology is negative, I would then proceed with a bronchoscopy and mediastinal lymph node sampling to get the diagnosis and stage. If the cytology from the thoracentesis is positive, than a bronch is not necessary.
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