The Role of Abrams Percutaneous Pleural Biopsy in the Investigation of Exudative Pleural Effusions

Chakrabarti, Biswajit; Ryland, I.; Sheard, Jon; Warburton, Chris; Earis, J. E.

doi:10.1378/chest.129.6.1549

Cited by 78 publications

(55 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, the pleural biopsies were performed by an experienced physician who had completed more than 200 procedures before 2007, and the current evidence is that the diagnostic yield of the technique does not seem to depend greatly on the experience of the operator. 18 In our study there were no significant differences in the characteristics of the 2 groups, but the diagnostic yield for malignant pleural effusion was 17% higher in the ultrasound group. …”

Section: Discussioncontrasting

confidence: 51%

“…12,15 A pleural biopsy can be performed blind, image guided, or thoracoscopy guided. 1,2,[16][17][18] The optimal method for obtaining pleural tissue and a diagnosis in subjects with exudative pleural effusion of unknown etiology is controversial. 4 An important benefit of thoracoscopy is the ability to obtain a diagnosis, drain the effusion, and perform a pleurodesis during the same procedure.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Thoracic Ultrasound-Assisted Selection for Pleural Biopsy With Abrams Needle

Botana-Rial¹,

Leiro-Fernández²,

Represas-Represas³

et al. 2013

Respir Care

View full text Add to dashboard Cite

BACKGROUND: Closed pleural biopsy (CPB) in patients with malignant pleural effusion is less sensitive than cytology. Ultrasound-assisted CPB allows biopsies to be performed in the lower thoracic parietal pleura, where secondary spread from pleural metastases is initially more likely to be found. We analyzed whether choosing the point of entry for CPB with thoracic ultrasound assistance influences the diagnostic yield in malignant pleural effusion. METHODS: This prospective study included patients who underwent CPB performed by an experienced pulmonologist in 2008 -2010 (group A) and thoracic ultrasound was used to select the biopsy site. The results were compared with a historical series of CPB performed by the same pulmonologist without the assistance of thoracic ultrasound (group B). An Abrams needle was used in all cases. We analyzed the obtaining of pleural tissue and the diagnostic yield. RESULTS: We included 114 CPBs from group A (23% tuberculous pleural effusion, 27% malignant pleural effusion) and 67 CPBs from group B (24% tuberculous pleural effusion, 30% malignant pleural effusion) (P ‫؍‬ .70). Pleural tissue was obtained in 96.5% of the group A CPBs and 89.6% of the group B CPBs (P ‫؍‬ .05). The diagnostic yields of CPB for tuberculous pleural effusion and malignant pleural effusion in group A were 89.5% and 77.4%, respectively, and 91.7% and 60%, respectively, in group B (P ‫؍‬ .80 for tuberculous pleural effusion, and P ‫؍‬ .18 for malignant pleural effusion). CONCLUSIONS: Selecting the point of entry for CPB using thoracic ultrasound increases the likelihood of obtaining pleural tissue and the diagnostic yield, but without statistical significance. We recommend ultrasound-assisted CPB to investigate pleural effusion, since the diagnostic yield of a pleural biopsy with an Abrams needle increased by > 17% in subjects with malignant pleural effusion.

show abstract

Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Thoracic Ultrasound-Assisted Selection for Pleural Biopsy With Abrams Needle

Botana-Rial¹,

Leiro-Fernández²,

Represas-Represas³

et al. 2013

Respir Care

View full text Add to dashboard Cite

show abstract

“…Thoracoscopic biopsy is considered the gold standard diagnostic method and case series have reported diagnostic sensitivity to range from 94-98% (19)(20)(21). CT-guided needle biopsy is also commonly used and has a reported sensitivity of 83-88% (22)(23)(24)(25)(26). The International Mesothelioma Interest Group (IMIG) established diagnostic criteria based on cytology.…”

Section: Introductionmentioning

confidence: 99%

Novel systemic therapy against malignant pleural mesothelioma

Mancuso

Neal

2017

Transl. Lung Cancer Res.

View full text Add to dashboard Cite

Malignant pleural mesothelioma is an aggressive tumor of the pleura with an overall poor prognosis. Even with surgical resection, for which only a subset of patients are eligible, long term disease free survival is rare. Standard first-line systemic treatment consists of a platinum analog, an anti-metabolite, and sometimes anti-angiogenic therapy, but there is currently no well-established standard therapy for refractory or relapsed disease. This review focuses on efforts to develop improved systemic therapy for the treatment of malignant pleural mesothelioma (MPM) including cytotoxic systemic therapy, a variety of tyrosine kinase inhibitors and their downstream effector pathways, pharmacologic targeting of the epigenome, novel approaches to target proteins expressed on mesothelioma cells (such as mesothelin), arginine depletion therapy, and the emerging role of immunotherapy. Overall, these studies demonstrate the challenges of improving systemic therapy for MPM and highlight the need to develop therapeutic strategies to control this disease.

show abstract

“…The number was also reduced further when case reports were excluded. From May 2003 through June 2009, a total of 1 guideline, 3 2 meta-analyses, 4,5 9 literature reviews, 6-14 1 randomized controlled trial, 15 and 9 clinical studies [16][17][18][19][20][21][22][23][24] on the practical investigation and diagnosis of pleural effusion were published in peer-reviewed journals.…”

Section: Resultsmentioning

confidence: 99%

Diagnosis of Pleural Effusion: A Systematic Approach

McGrath

Anderson

2011

American Journal of Critical Care

122

View full text Add to dashboard Cite

In most diseases related to pleural effusion, the fluid analysis yields important diagnostic information, and in certain cases, fluid analysis alone is enough for diagnosis. The many important characteristics of pleural fluid are described, as are other complementary investigations that can assist with the diagnosis of common and rare pleural effusions. For a systematic review of pleural effusion, a literature search for articles on the practical investigation and diagnosis of pleural effusion was done. Articles included guidelines, expert opinion, experimental and nonexperimental studies, literature reviews, and systematic reviews published from May 2003 through June 2009. The search yielded 1 guideline, 2 meta-analyses, 9 literature reviews, 1 randomized control trial, and 9 clinical studies. On the basis of class IIa or class I evidence from these articles, a step by step approach is recommended for investigating a pleural effusion, beginning with assessment of the medical history, clinical examination, radiology, pleural fluid evaluation, and finally, if no diagnosis is forthcoming, a pleural biopsy under image guidance or thoracoscopy.

show abstract

The Role of Abrams Percutaneous Pleural Biopsy in the Investigation of Exudative Pleural Effusions

Cited by 78 publications

References 26 publications

Thoracic Ultrasound-Assisted Selection for Pleural Biopsy With Abrams Needle

Thoracic Ultrasound-Assisted Selection for Pleural Biopsy With Abrams Needle

Novel systemic therapy against malignant pleural mesothelioma

Diagnosis of Pleural Effusion: A Systematic Approach

Contact Info

Product

Resources

About