Thoracoscopic Pleural Lavage and Brushing in Undiagnosed Pleural Effusion

Inclusion Criteria: * Patients will have documented exudative pleural effusion in whom the initial pleural tapping and closed pleural biopsy (CPB) will not be conclusive * strong clinical and radiological data suggestive for alternative pathological diagnosis * who will be admitted to our department Exclusion Criteria: * Patients with excess rib crowding with narrow inter-costal space and loculated pleural effusion cannot undergo thoracoscopy * Patients with bleeding diathesis * hemodynamic instability * Arrhythmias * intractable cough cannot be eligible to do thoracoscopy