Safety and yield of blind pleural biopsy using Tru-cut needle in exudative pleural effusion

Fazal Akbar, Salah Matti

Abstract


Introduction: Pleural biopsy is a vital diagnostic tool for investigation of an exudative pleural effusion. Biopsy performed with image guidance is commonly recommended but blind procedure is equally safe and effective. We investigated safety and efficacy of using Tru-cut cutting needle to biopsy pleura without image guidance for investigation of undiagnosed exudative pleural effusion.
Methods: Patients with undiagnosed moderate size unilateral exudative pleural
effusion were included. Samples obtained were sent for histology and mycobacterial cultures. Subjects with inadequate samples or non-diagnostic results were referred for CT guided or thoracoscopic biopsies. Diagnosis and outcome was studied at 3years following the procedure.
Results: 27 patients underwent biopsy, with adequate pleural samples obtained from 24 patients (89%). With blind technique, 37% had underlying malignancy, 22 % chronic inflammation and 4% granulomatous infection with overall sensitivity of 74%. Two third (10/15) of patients with malignant effusion at 3 years were picked up by Tru-cut biopsy at presentation. All patients tolerated procedure with no immediate or late complications.
Conclusion: Pleural biopsy with Tru-cut needle is a safe and effective method of
investigation of an undiagnosed exudative pleural effusion.


Keywords


Pleural biopsy; CT; Pleural Effusion

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