DIAGNOSTIC YIELD OF ABRAMS PLEURAL BIOPSY IN PATIENTS PRESENTING WITH LYMPHOCYTIC EXUDATIVE PLEURAL EFFUSION.

Abstract

Background: Pleural effusion is the one of the most common clinical conditions encountered in pulmonology clinics and the routinely performed tests on pleural fluid do not provide definitive diagnosis in majority of the cases. Medical thoracoscopy with pleural biopsy under direct vision of the abnormal area provides the highest diagnostic yield. Abrams closed needle pleural biopsy is a conventional and cheaper procedure which can help in the definitive diagosis in cases of undiagnosed pleural effusion. Objectives: To determine the diagnostic yield of abrams pleural biopsy in patients presenting with lymphocytic exudative pleural effusion. Study Design: Cross Sectional Study. Setting: Department of Pulmonology Nishtar Hospital Multan; Tertiary care hospital of 1180 beds. Period: Six months. Results: There were 145 patients diagnosed with lymphocytic exudative pleural effusion. Of these 145 study cases, males were 83/145 (57.2%) whereas females were 62/145 (42.8%). Mean age of our patients was 41.62 ± 13.63 years while mean duration of illness was 7.0 ± 3.24 weeks. When the frequencies of various diagnosis established on the basis of histopathology results obtained from the tissue specimen obtained with Abrams pleural biopsy was noted, Tuberculosis was the major cause of lymphocytic exudative pleural effusion as its frequency was noted to be in 81/145 (55.9%) of our patients while malignancy was present in 26/145 (17.9%) of our study cases whereas the histopathology turned out to be inconclusive in 38/145 (26.2%) showing non-specific inflammation. The diagnostic yield of Abrams pleural biopsy turned out to be 73.8% whereas it was unable to establish diagnosis in 26.2%. Conclusion: Abrams needle pleural biopsy is simple, reliable and safe method of diagnosis with a good diagnostic yield. Routine use of this procedure in patients with lymphocytic exudative pleural effusion can lead to a definitive diagnosis in majority of patients.