A Pleural-Biopsy Punch

Abrams, L. D.

doi:10.1016/s0140-6736(58)92521-2

Cited by 160 publications

(47 citation statements)

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“…Both samples were centrifuged for 10 min at 1,000 × g, and the supernatants were stored at -40°C pending assay. Pleural biopsies were performed with a COPE needle [12] or ABRAMS needle [13], except when a transudate was suspected.…”

Section: Methodsmentioning

confidence: 99%

Adenosine deaminase (ADA) isoenzyme analysis in pleural effusions: diagnostic role, and relevance to the origin of increased ADA in tuberculous pleurisy

Valdés¹,

José²,

Álvarez³

et al. 1996

Eur Respir J

143

100

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The rise in adenosine deaminase (ADA) activity in the pleural fluid of tuberculous pleurisy patients, though used for diagnosis, is of unknown origin. In this work, we determined ADA activity and the activities of 2'-deoxyadenosine deaminase and ADA-2 in 350 patients. We also considered whether the results throw light on the origin of high pleural fluid ADA in tuberculous pleurisy and estimated the diagnostic efficiency of 2'-deoxyadenosine deaminase, ADA-2 and total ADA activities with and without the inclusion of the 2'-deoxyadenosine deaminase/ADA activity ratio in a combined criterion.The 350 pleural effusions were classified by previously established criteria as transudates (60 males/18 females) or as tuberculous (49 males/27 females), neoplastic (50 males/39 females), parapneumonic (36 males/19 females), empyematous (11 males/ 3 females), or miscellaneous (25 males/13 females) exudates. Total ADA, ADA-2 and 2'-deoxyadenosine deaminase activities were, respectively, 127.5±2.9, 103±29.5 and 42.8±14 U·L -1 in tuberculous exudates. With diagnostic thresholds of 47, 40 and 22 U·L -1 respectively, the sensitivities of ADA, ADA-2 and 2'-deoxyadenosine deaminase for tuberculosis were 100, 100 and 95%; their specificities 91, 96 and 92%; and their efficiencies 93, 97 and 93%, respectively. One hundred and one effusions (all 76 tuberculous, 12 neoplastic, 4 parapneumonic and 9 empyematous exudates) had total ADA levels >47 U·L -1 ; of these, 8 neoplastic, 1 parapneumonic and all the tuberculous exudates had a 2'-deoxyadenosine deaminase/ADA activity ratio <0.49. The criterion of simultaneously having ADA >47 U·L -1 , ADA-2 >40 U·L -1 and a 2'-deoxyadenosine deaminase/ADA activity ratio <0.49 was satisfied by all the tuberculous effusions but only eight others (all neoplastic) (sensitivity 100%, specificity 97%, efficiency 98%).We conclude that: 1) high total ADA activity in tuberculous pleural effusions is due mainly to an increase in ADA-2, and, therefore, originated from the only known source monocytes and macrophages; 2) ADA-2 was a more efficient diagnostic marker of tuberculous pleurisy than total ADA activity, although the difference was not statistically significant; and 3) among effusions with high total ADA the 2'-deoxyadenosine deaminase/ADA activity ratio differentiates tuberculous effusions from empyemas and parapneumonic effusions, but fails to discriminate well between tuberculous and neoplastic effusions.

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Section: Methodsmentioning

confidence: 99%

Adenosine deaminase (ADA) isoenzyme analysis in pleural effusions: diagnostic role, and relevance to the origin of increased ADA in tuberculous pleurisy

Valdés¹,

José²,

Álvarez³

et al. 1996

Eur Respir J

143

100

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“…Closed pleural biopsy CPB was first described by ABRAMS [94] and COPE [95] in the mid-20th century as an alternative means of obtaining pleural tissue without resorting to surgical thoracotomy. Its continued use more than five decades later can be attributed to factors including ease of use, low cost and tolerability to patients.…”

Section: Medical Thoracoscopy and Closed Pleural Biopsymentioning

confidence: 99%

Advanced medical interventions in pleural disease

et al. 2016

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The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease. @ERSpublications Technological advances and greater availability of techniques give a broad range of interventions for pleural disease http://ow.ly/ZNya2

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“…Percutaneous pleural biopsy was originally described in the 1950s by Abrams and Cope, after whom the two original reverse-bevel "closed" needles are named [10,11]. Abrams needles are still used in some countries, as they can be employed at the bedside without imaging.…”

Section: Blind Closed-needle Biopsiesmentioning

confidence: 99%

Pleural biopsies in undiagnosed pleural effusions; Abrams vs image-guided vs thoracoscopic biopsies

Bibby

Maskell

2016

Current Opinion in Pulmonary Medicine

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms However this service is not universally available and may be unsuitable for some patients.Image-guided cutting-needle biopsies under computed tomography or ultrasound guidance have high diagnostic rates and are useful in a wide patient population. The main role of Abrams biopsies is in the diagnosis of tuberculous pleuritis in resource-poor settings.

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A Pleural-Biopsy Punch

Cited by 160 publications

References 0 publications

Adenosine deaminase (ADA) isoenzyme analysis in pleural effusions: diagnostic role, and relevance to the origin of increased ADA in tuberculous pleurisy

Adenosine deaminase (ADA) isoenzyme analysis in pleural effusions: diagnostic role, and relevance to the origin of increased ADA in tuberculous pleurisy

Advanced medical interventions in pleural disease

Pleural biopsies in undiagnosed pleural effusions; Abrams vs image-guided vs thoracoscopic biopsies

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