RESUMO
The present study was designed to evaluate the diagnostic yield and safety of closed pleural biopsy using Abram's needle in patients with suspected tuberculous pleural effusions. 115 patients [86 males and 29 females] with suspected tuberculous pleural effusion were retrospectively observed in the period from January 2004 to December 2006. All patients were clinically evaluated and in addition to routine laboratory investigations, chest X-ray and sputum for acid fast bacilli [AFB] were examined. Thoracocentesis, followed by closed pleural biopsy was performed in all patients in the same setting. A total of 2 - 3 pleural biopsy pieces were obtained in each patient and were sent for histopathological examination. Pleural fluid was examined for microbiology [Gram stain, Ziehl-Neelson stain], biochemistry [protein, LDH, sugar] and cytology [for malignant cells, total and differential cell count]. The analysis of pleural fluid showed exudative fluid in 111 patients [97%] and transudate in four patients [3%]. Histological analysis revealed caseous granulomatous inflammation in 47 patients [41%] and non-caseous granulomatous inflammation in 16 patients [14%] Non-specific inflammation was observed in 38 [33%] patients and malignancy in four patients [3%] and the biopsies were inadequate for examination in 10 patients [9%]. Out of the 115 patients, 92 were finally diagnosed as pleural TB in which histopathological examination aided in the diagnosis of 63 patients [69%]. The pleural fluid culture was positive in four patients [4.4%] and the direct AFB was positive in two patients [2.2%]. The procedure was well tolerated and complications were detected only in 11 patients. We concluded that closed pleural biopsy was a simple, safe, and effective method to rapidly diagnose pleural tuberculosis