SESSION TITLE: Pleural Disease
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Wednesday, October 29, 2014 at 02:45 PM - 04:15 PM
PURPOSE: Medical Thoracoscopy and Video Assisted Thoracoscopic Surgery (VATS) have revolutionized the diagnostic value in undiagnosed cases of exudative pleural effusions. However, Closed Pleural Biopsy is still being useful due to its cost and ease of procedure in experienced hands. Sometimes, etiological diagnosis of exudative pleural effusions is difficult with biochemical, microbiological and cytological analysis of fluid alone. The aim of the study is to evaluate the yield of Closed Pleural Biopsy in diagnosing unilateral exudative pleural effusions, confirmed by pleural biochemistry, in cases admitted during 2011 till 2012.
METHODS: All the cases who were admitted with unilateral pleural effusions in the tertiary hospital of Brunei Darussalam and undergone Closed Pleural Biopsy with Abrams Needle during the year 2011 till 2012 are included. Those cases which have undergone VATS biopsy for diagnosis have been excluded. Pleural biopsy was subjected to histopathology.
RESULTS: Out of 86 patients who underwent pleural biopsy during the two years period, 30 were excluded as they were subjected to VATS biopsy. Out of 56 patients who underwent Closed Pleural Biopsy with Abrams needle, 30 were male and 26 were female. Age ranged from 17 to 86 with a median age of 60. Histopathology showed definitive diagnosis in 32 (57.14%) patients. Malignancy is seen in 13 (23.21%) out of which Metastatic Adenocarcinoma are nine, one each of Malignant Lymphoma, Papillary Adenocarcinoma, Metastatic Germinoma and Inflammatory Myofibroblastic Tumor. Tuberculosis was reported in 18 (32.14%). One biopsy revealed Amyloidosis. Inflammation is reported in 8 (14.28%) cases, Acute in 2 cases and Chronic in 6 cases respectively. Three biopsies were reported as Muscle tissue, two cases as thickened pleura and 11 (19.64%) cases as inconclusive.
CONCLUSIONS: Closed pleural biopsy with Abram’s needle is still could be a diagnostic and economical intervention in exudative pleural effusion cases with a definitive yield of diagnosis in 57.14% of the cases.
CLINICAL IMPLICATIONS: Closed pleural biopsy could still be a good diagnostic procedure in cases with exudative pleural effusions in confirmation of diagnosis and in turn could save not only manpower but also could reduce the burden on health economy in terms of avoiding more invasive interventions like thoracoscopic biopsy.
DISCLOSURE: The following authors have nothing to disclose: Panduru Kishore, Manoj Pethe, Yin Kyi Oo, Khalizah Jamil, Luke Mathew
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