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Malignant pleural disease — RACP Written MCQ

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HardRespiratoryMalignant pleural diseaseRACP Written

A 61-year-old man has unilateral pleural effusion, weight loss and dullness to percussion. Pleural fluid is exudative with lymphocyte predominance; cytology is negative. CT shows pleural nodularity. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Thoracoscopy with pleural biopsy

Pleural nodularity and exudative lymphocytic effusion with negative cytology require tissue diagnosis. Thoracoscopy gives high diagnostic yield for malignancy and tuberculosis.

Reference: Australian Asthma Handbook; TSANZ guidance; Therapeutic Guidelines: Respiratory