Case Report: Diagnostic utility of pleural tissue debris retrieved during percutaneous drainage for the diagnosis of malignant pleural effusion and molecular profiling.
- 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
- 2Department of Pathology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
- 3Department of Precision Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Abstract
Background
Although pleural tissue debris is occasionally encountered in the drainage systems of patients undergoing catheter or chest tube drainage, its clinical utility has not been reported. Here, we report two cases in which pleural tissue debris retrieved during catheter drainage enabled a definitive diagnosis of malignant pleural effusion (MPE) and molecularly guided treatment decisions.Case presentation
The first case involved a 67-year-old woman with rheumatoid arthritis-associated interstitial lung disease who developed a right pleural effusion suggestive of lung cancer with pleural metastasis. Invasive procedures for tissue acquisition were required; however, biopsy was withheld because of the high risk of pneumothorax and acute exacerbation of the underlying lung disease. Tissue debris was incidentally found in the drainage system. The tissue was adequate for pathological examination and revealed lung squamous cell carcinoma without genomic alterations. Chemoimmunotherapy was initiated without further invasive procedures. The second case involved a 78-year-old woman who presented with a left pleural effusion and a brain lesion, highly suggestive of lung cancer with brain metastasis. She declined invasive diagnostic procedures; however, tissue debris was incidentally collected from the drainage bottle and diagnosed as lung adenocarcinoma. Molecular testing revealed that the tumor harbored an epidermal growth factor receptor (EGFR) L858R mutation, allowing first-line targeted therapy to be initiated without further invasive testing.Conclusion
To the best of our knowledge, this is the first case report to describe the clinical utility of pleural tissue debris for the diagnosis of MPE and its suitability for molecular profiling. Our report highlights that this previously overlooked byproduct of routine pleural drainage can provide adequate material for histopathological diagnosis, immunohistochemistry, and molecular testing in patients with MPE, particularly those for whom conventional biopsy is contraindicated or declined.
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BibTeX
@article{kim2026case,
title = {{Case Report: Diagnostic utility of pleural tissue debris retrieved during percutaneous drainage for the diagnosis of malignant pleural effusion and molecular profiling.}},
author = {Jiwon Kim and Han Gyeol Kim and Seung Hyeun Lee},
journal = {Frontiers in oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1967294},
url = {https://europepmc.org/article/MED/42903229},
note = {CC BY},
}
RIS
TY - JOUR
TI - Case Report: Diagnostic utility of pleural tissue debris retrieved during percutaneous drainage for the diagnosis of malignant pleural effusion and molecular profiling.
AU - Jiwon Kim
AU - Han Gyeol Kim
AU - Seung Hyeun Lee
PY - 2026
DA - 2026/10/06
JO - Frontiers in oncology
DO - 10.3389/fonc.2026.1967294
UR - https://europepmc.org/article/MED/42903229
AB - Background Although pleural tissue debris is occasionally encountered in the drainage systems of patients undergoing catheter or chest tube drainage, its clinical utility has not been reported. Here, we report two cases in which pleural tissue debris retrieved during catheter drainage enabled a definitive diagnosis of malignant pleural effusion (MPE) and molecularly guided treatment decisions.Case presentation The first case involved a 67-year-old woman with rheumatoid arthritis-associated interstitial lung disease who developed a right pleural effusion suggestive of lung cancer with pleural metastasis. Invasive procedures for tissue acquisition were required; however, biopsy was withheld because of the high risk of pneumothorax and acute exacerbation of the underlying lung disease. Tissue debris was incidentally found in the drainage system. The tissue was adequate for pathological examination and revealed lung squamous cell carcinoma without genomic alterations. Chemoimmunotherapy was initiated without further invasive procedures. The second case involved a 78-year-old woman who presented with a left pleural effusion and a brain lesion, highly suggestive of lung cancer with brain metastasis. She declined invasive diagnostic procedures; however, tissue debris was incidentally collected from the drainage bottle and diagnosed as lung adenocarcinoma. Molecular testing revealed that the tumor harbored an epidermal growth factor receptor (EGFR) L858R mutation, allowing first-line targeted therapy to be initiated without further invasive testing.Conclusion To the best of our knowledge, this is the first case report to describe the clinical utility of pleural tissue debris for the diagnosis of MPE and its suitability for molecular profiling. Our report highlights that this previously overlooked byproduct of routine pleural drainage can provide adequate material for histopathological diagnosis, immunohistochemistry, and molecular testing in patients with MPE, particularly those for whom conventional biopsy is contraindicated or declined.
SN - 2234-943X
ER -