Pleural biopsy by: abrams punch needle pattern and frequency of histopathological lesions encountered in patients with exudative pleural effusion

Pleural effusion is a very common problem in medical practice, despite the magnitude of the problem; there is severe lack of local data on this problem. The exudative pleural effusion presents a diagnostic problem. In the western countries malignancy is the commonest lesion while in Pakistan tuberculosis is a common histopathological lesion but no study is available to highlight the causes of exudative pleural effusion. To find out by histopathological specimen different types of lesions encountered in exudative pleural effusion using Abrams punch needle with blind technique. Materials and Study was carried out form January 1998 to January 2002. In Abassi Shaheed Hospital medical unit 1 and Saifee hospital [private hospital]. All patients with exudative pleural effusion were included in the study. The patients after consent were subjected to pleural biopsy using local anesthesia. Total numbers of patients were 85.Definitive histopathological results were obtained in 80 patients, which is 93.75% of the total patients. Of those with positive results 49 [61%] were females and 31 [39%] were males. Tuberculosis accounted for 75% of [60/80] patients. Malignancy was seen in 22.5%[18/80]. The commonest malignancy was adenocarcinoma followed by squamous carcinoma and lymphoma. Tuberculosis is the commonest cause of pleural effusion [75%]in this study. In any patients with exudative pleural effusion in our setting, this should be the fore most diagnosis. Malignancy can mimic tuberculous pleural effusion, clinically and radiologically. There fore close needle biopsy [Abrams] is valuable in establishing diagnosis. The pleural biopsy has a yield of 93.7%, which is high for a blind procedure

Indications and relative frequencies for diseases requiring closed tube thoracostomy in medical patients

To determine the indications and relative frequencies for diseases requiring closed tube thoracostomy in medical patients. To determine the frequency of tuberculosis as a causative factor for different indications and the time required for the chest tube to be withdrawn in different diseases. To compare the male: female ratio and also the ratio of right and left side pleural involvement requiring closed tube thoracostomy. Study Design: Descriptive study on 70 patients. Settings: Medical units 1, 2 and 3 of Abbasi Shaheed Hospital, Karachi. Subjects: All patients of both sexes between the age groups of 13 years to 75 years have been included in the study. The Study was done on 70 patients. The frequency of male: female ratio was 37 [52.9%] and 33 [47.1%] respectively. The commonest indication for closed tube thoracostomy was pneumothorax which occurred in 29 [41.4%] patients and the least common was parapneumonic effusion [PNE] affecting 5[7.1%] patients. Tuberculosis [TB] was the single most prevalent etiological factor and occurred in 29 [41.4%] patients. It also required the longest duration for tube placement - average 49.28 +/- 4.70 days. Pleural involvement for right or left side was 36 [51.4%] and 34 [48.6%] respectively. Our study demonstrated that pneumothorax was the commonest disease, requiring closed tube thoracostomy. The most common etiological factor was tuberculosis and patients with tuberculosis also required longest duration of time for chest tube placement