EXUDATIVE PLEURAL EFFUSION; Comparison of diagnostic yield between pleuroscopic and closed percutaneous pleural biopsies in patients

Abstract

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 Key words:Pleuroscopy, Abrams biopsy, pleural effusion and biopsy.