Ultrasound guided needle pleural biopsy in patients with undiagnosed pleural effusion

Cases of pleural effusion represent a great challenge for pulmonologists and ultrasound is considered as an important tool for diagnosis of these cases. To identify the role of percutaneous ultrasound guided needle biopsy in patients with undiagnosed pleural effusion. This study was conducted on 30 patients [26 males and 4 females] with undiagnosed pleural effusion using ultrasound guided pleural biopsies using a tru-cut needle. Diagnostic yield, pathological tissue characterization, complications were recorded. The total number of diagnosed cases was 24 [80%]; malignancies detected in 17 cases [9 as mesothelioma [30%], 8 as bronchogenic carcinoma with pleural metastasis [26.7%]], tuberculous effusion in 2 cases [6.7%], inflammatory lung masses in 3 cases [10%], para-pneumonic effusion in 2 cases [6.7%] and 6 cases were not diagnosed [20%]. In diagnosed cases tissues were classified according to pathological characterization into pleural tissue in 4 cases [16.7%], pleural mass tissue in 8 cases [33.3%], mixed pleural tissue and pleural mass tissue in 2 cases [8.3%] and mixed pleural tissue with pleural and parenchyma! mass tissue in 10 cases [41.7%]. Complications were in the form of bleeding at the site of procedure in 1 case [3.3%], shock in 1 case [3.3%] and pneumothorax in 2 cases [6.7%]. Sensitivity, specificity and accuracy of ultrasound guided pleural biopsy were 80, 76 and 80% respectively. Ultrasound-guided pleural biopsy is an effective and safe technique in patients with undiagnosed pleural effusion. It allows accurate needle placement, shorter procedure time

Comparative study between postoperative and spontaneous pyogenic lumber spondylodiscitis

The aim of this study was to present magnetic resonance imaging [MRI] findings in patients with pyogenic lumber Spondylodiscitis and to compare the clinical and imaging features of postoperative [POS] and spontaneous Spondylodiscitis [SS]. MRI was performed in 25 patients aged 29-70 y, proved to have lumber spondylodiscitis. Patients underwent MRI including sagittal T1W and T2W images and axial T1W images before and after I.V injection of gadolinium supplemented with diffusion study. Twenty patients had SS and 5 patients had POS. Patients with POS tended to be younger [52 versus 69 years], with less frequent underlying diseases [20 versus 90%] and a more prolonged interval between symptom onset and diagnosis [16 versus 4 weeks] than patients with SS. Vertebral edema tended to be more frequent in POS and was located more posterior than in SS. Spondylodiscitis is associated with specific clinical and imaging features possibly related to pathophysiologic characteristics. Knowledge of these characteristics should help reduce the current delay in the diagnosis Spondylodiscitis especially in the postoperative type