EXUDATIVE PLEURAL EFFUSION

Comparison of diagnostic yield between pleuroscopic and closed percutaneous pleural biopsies in patients

Abstract

Objectives: To compare the pleuroscopic and closed pleural biopsy by Abrams
needle in terms of diagnostic yield and obtaining specific diagnosis in cases of exudative pleural
effusion. Study Design: Cross sectional study. Period: August 2014 to February 2015. Setting:
Department of Thoracic Medicine Jinnah Post Graduate Medical Center Karachi. Methodology:
All patients with pleural effusion who were admitted and fulfilling the inclusion criteria were
included in the study .Closed pleural biopsy using Abrams needle followed by pleuroscopy with
a flexible pleuroscope was performed from the same incision, in the same sitting. The samples
were sent for histopathology. To control bias samples were coded as A and B and the code
was not known to the histopathologist. Results: Among 60 patients, Mean age was 42.85 years
with ±18.2 standard deviation and male to female ratio was 1.6 :1. Specific diagnosis through
pleuroscopic biopsy had shown 27 (45%) cases of tuberculosis, 25 (41.7%) of adenocarcinoma,
5 (8.3%) of chronic non specific inflammation, one (1.7%) case of lymphoma and 2 (3.3%)
cases could not be reached for any diagnosis. Conclusion: Pleuroscopy has better yield than
the Abrams needle biopsy in terms of both diagnostic yield and specific diagnosis