Diagnostic yeild of pleural biopsy in exudative pleural effusion

ABSTRACT

To determine the diagnostic yield of pleural biopsy in exudative pleural effusion. This prospective observational study comprising 50 patients of exudative pleural effusion, was conducted in department of Medicine, Hayatabad Medical complex [HMC], Peshawar. All were included from the hospital OPD. Patients, who were having transudative pleural effusion and those, who were very emaciated, were excluded from the study. History, clinical examination and baseline investigations like FBC, X-Ray chest PA view, Mantoux test, Renal functions and pleural fluid analysis were performed. Pleural biopsy was performed through Abram's pleural biopsy needle. Out of 50 patients, 33 were males and 17 were females. Regarding the presenting symptoms, 86% presented with nonproductive cough, 66% presented with chest pain, 36% with breathlessness and 44% with fever. In 45/50 [90%] patients an adequate pleural tissue was obtained. Out of 45 patients, 40 [89%] patients were having positive yield and 5 [11%] cases had nonspecific inflammation. Out of 40 patients, 27 [67.5%] were having granulomatous inflammatory changes presumptive of tuberculosis, 10 [25%] patients had malignancy and 3 [7.5%] had miscellaneous conditions like Para pneumonic effusion etc. The most common complication was biopsy site pain in all cases. Only 3 [6%] patients developed pneumothorax during the study period. Pleural biopsy has a high diagnostic yield. It is safe, simple and clearly differentiates between malignant and tuberculous effusions