The Optimal Number of Pleural Biopsy Specimens for a Diagnosis of Tuberculous Pleurisy

Kirsch, Carl M.; Jensen, William A.; Kagawa, Frank T.; Wehner, John H.; Kroe, D M; Azzi, Raymond L.

doi:10.1378/chest.112.3.702

Cited by 81 publications

(47 citation statements)

References 24 publications

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“…According to KIRSCH et al [62], the yield increased significantly when six or more specimens were taken or when at least two specimens contained pleural tissue (which was not always obtained).…”

Section: Pleural Needle Biopsy In Tuberculous Pleurisymentioning

confidence: 99%

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Rodríguez-Panadero

Janssen²,

Astoul³

2006

Eur Respir J

154

111

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Section: Pleural Needle Biopsy In Tuberculous Pleurisymentioning

confidence: 99%

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Rodríguez-Panadero

Janssen²,

Astoul³

2006

Eur Respir J

154

111

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“…Kirsch et al found a direct correlation between the yield of closed pleural biopsy and the number of biopsy samples given. 16 The low sample size of the study also can be a reason for the low sensitivity of the test. The high yield for TB when compared to malignancy is because of the pleural distribution of the lesions.…”

Section: Figure 1: Distribution Of Agementioning

confidence: 99%

Comparison of diagnostic yield and complications of bronchoscopy, closed pleural biopsy and medical thoracoscopic pleural biopsies in undiagnosed pleural effusions

et al. 2017

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INTRODUCTIONPleural effusion is the abnormal accumulation of fluid in the pleural space. It can be transudate or exudates and Light's criteria help to differentiate them.1 Exudative pleural effusion is a commonly encountered clinical scenario among both respiratory and non-respiratory specialists. In humans, approximately 75% of the cells in the pleural fluid are macrophages, 25% are lymphocytes and mesothelial cells, neutrophils and eosinophils accounting for less than 2% each.2 The precise pathophysiology of fluid accumulation vary based upon ABSTRACT Background: Undiagnosed exudative pleural effusion is a commonly encountered clinical scenario, which requires further evaluation. This study was aimed to analyze the diagnostic yield and complications of three proceduresBronchoscopy, closed (Abram's) pleural biopsy and medical thoracoscopy. Further, this study assessed whether combining closed pleural biopsy with bronchoscopy can be a substitute for medical thoracoscopy. Methods: An observational study was conducted among people with undiagnosed exudative pleural effusion. Initially, closed pleural biopsies were performed with Abrams needle and multiple tissue fragments were taken through the incision and the samples were sent in formalin to the laboratory for histopathology examination. For thoracoscopy, a cannula of 10 mm diameter with blunt trocar was inserted into the pleural cavity and semi rigid thoracoscope was introduced through the trocar. Bronchoscopy was performed 48 hours after thoracoscopy. Sensitivity, specificity and positive and negative predictive values were calculated and compared. Results: Out of 25 people, 14 were diagnosed to have malignancy and 7 were diagnosed tuberculosis. The overall sensitivity of the three procedures were 28.5% for closed pleural biopsy, 14.2% for bronchoscopy, 95.2% for medical thoracoscopy, 42.8% for the combined pleural biopsy and bronchoscopy. The complication rate was lowest for bronchoscopy (4%), followed by medical thoracoscopy (8%) and closed pleural biopsy (16%). Conclusions: Medical thoracoscopy is a comparatively safe procedure which has got the highest sensitivity for the diagnosis of undiagnosed exudative pleural effusions. Bronchoscopy combined with closed pleural biopsy, the diagnostic yield was increased (than that of individual yield), but cannot be a substitute for medical thoracoscopy.

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“…Bir olgunun ADA düzeyi 24 IU idi. Literatürde, TB plörezi tan s nda, histopatolojik incelemeyle %50-90 oran nda pozitiflik elde edilirken, s v ve dokuda bakteriyolojik incelemelerin ilave edilmesi ve biyopsi say s n n art r lmas yla tan oranlar n n yükseldi i bildirilmi tir [20][21][22]. Olgular m z n tamam na biyopsi ile tan konulmu tu (n:21, %100), 11 (%52) olguda ARB için mikrobiyolojik inceleme yap lm ve Löwenstein-Jensen (LJ) besiyerine yap lan ekimde 8 (%73) olguda Mycobacterium tuberculosis komplex üremi ti.…”

Section: Tarti Maunclassified

The Characteristics of Cases with Extrapulmonary Tuberculosis in a University Hospital

Inonu¹,

Koseoglu²,

Pazarli³

et al. 2010

Tur Toraks Der

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Objective: Tuberculosis (TB) can involve most tissues and organs besides the lungs and this form is called extrapulmonary tuberculosis (EPT). The diagnosis of EPT may be delayed due to organ-specific symptoms of the disease. Material and Method:In this study, the aim is to evaluate the cases who were diagnosed as EPT in our clinic between 2006-2009. Forty-four patient records were reviewed, retrospectively.Results: Twenty-nine (65.9%) cases were female, 15 (34.1%) cases were male. The mean age of the cases was 50.23±18.4 years and most were 25-34 years-old. Nine (21%) cases had a history of close contact. Seventeen (39%) cases had tuberculin tests in their records and thirteen (76%) of them had a positive result. The distribution according to sites of involvement of EPT cases were as follows: pleural TB (n:21, 47.7%), lymphadenitis TB (n:14, 31.8%), skin TB (n:3, 6.8%), bone-joint TB (n:2, 4.5%), urinary TB (n:1, 2.3%), gastrointestinal TB (n:1, 2.3%), laryngeal TB (n:1, 2.3%), breast TB (n:1, %2.3). Thirty-nine (89%) cases have completed the treatment successfully. Bulgular: Olgular n 29 (%65.9)'u kad n, 15 (%34.1)'i erkekti. Ya ortalamas 50.23±18.4 olan olgular en s k 25-34 ya gurubunda yo unla m t . Dokuz (%21) olgunun temas öyküsü mevcuttu, 17(%39) olgunun dosyas nda tüberkülin deri testi kayd vard ve bunlar n 13(%76)'ünde sonuç pozitifti. EPT olgular n n tutulum yerlerine göre da l m öyleydi: plevra TB (n:21, %47.7), TB lenfadenit (n:14, %31.8), deri TB (n:3, %6.8), kemik-eklem TB (n:2, %4.5), üriner sistem TB (n:1, %2.3), gastrointestinal sistem TB (n:1, %2.3), larinks TB (n:1, %2.3), meme TB (n:1, %2.3). Olgular n 39 (%89)'u tedavilerini ba ar l ekilde tamamlad . ConclusionSonuç: Ekstrapulmoner tüberküloz'lu olgular klinik özellikleriyle literatür e li inde tart ld . (Tur Toraks Der 2010; 11: 167-72) Anahtar sözcükler: Ekstrapulmoner tüberküloz, tüberküloz lenfadeniti, plevral tüberküloz, laringeal tüberküloz, deri tüber-külozu, kemik tüberkülozu

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The Optimal Number of Pleural Biopsy Specimens for a Diagnosis of Tuberculous Pleurisy

Cited by 81 publications

References 24 publications

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Comparison of diagnostic yield and complications of bronchoscopy, closed pleural biopsy and medical thoracoscopic pleural biopsies in undiagnosed pleural effusions

The Characteristics of Cases with Extrapulmonary Tuberculosis in a University Hospital

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