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

ABSTRACT

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