Diagnosis and Treatment of Pleural Effusion

Thoracic Ultrasound-Assisted Selection for Pleural Biopsy With Abrams Needle

“…After parapneumonic pleural effusion, the most frequent causes of exudative pleural effusion are malignant pleural effusion and tuberculous pleural effusion. [1][2][3] To differentiate among the various causes of exudative pleural effusion, biochemical, microbiological, and cytological analyses of the pleural liquid should be performed. 1,2 However, after an initial thoracocentesis, approximately 40% of patients remain undiagnosed; thus, the next step is a pleural biopsy.…”

“…[1][2][3] To differentiate among the various causes of exudative pleural effusion, biochemical, microbiological, and cytological analyses of the pleural liquid should be performed. 1,2 However, after an initial thoracocentesis, approximately 40% of patients remain undiagnosed; thus, the next step is a pleural biopsy. 1,2 Some controversy exists about the ideal procedure that should be used to perform a pleural biopsy.…”

“…1,2 However, after an initial thoracocentesis, approximately 40% of patients remain undiagnosed; thus, the next step is a pleural biopsy. 1,2 Some controversy exists about the ideal procedure that should be used to perform a pleural biopsy. 4 The pleural biopsy can be a closed pleural biopsy (CPB), pleural biopsy guided by imaging, or thoracoscopy.…”

“…4 The pleural biopsy can be a closed pleural biopsy (CPB), pleural biopsy guided by imaging, or thoracoscopy. 1,2 The diagnostic yield of CPB with respect to malignant pleural effusion is lower than that of cytology, with the reported sensitivities ranging from 48%-56% for CPB. [1][2][3] One possible reason for the low yield could be patchy involvement of the pleura in malignant pleural effusion.…”

“…1,2 The diagnostic yield of CPB with respect to malignant pleural effusion is lower than that of cytology, with the reported sensitivities ranging from 48%-56% for CPB. [1][2][3] One possible reason for the low yield could be patchy involvement of the pleura in malignant pleural effusion. This low yield does not occur in tuberculous pleural effusion, which has a diffuse expression throughout the pleural surfaces, and for which sensitivity can reach 85%.…”