Closed Pleural Biopsy is Still Useful in the Evaluation of Malignant Pleural Effusion

• Published in: Journal of laboratory physicians Vol. 4; no. 1; pp. 035 - 038
• Main Authors: Bhattacharya, Somnath, Bairagya, Tapan D, Das, Anirban, Mandal, Abhijit, Das, Sibes K
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01.01.2012; Medknow Publications and Media Pvt. Ltd; Thieme Medical Publishers Inc; Medknow Publications & Media Pvt Ltd; Thieme Medical and Scientific Publishers Pvt. Ltd
• Subjects: Biopsy; Chemotherapy; closed pleural biopsy; Diagnosis; Health care; malignant pleural effusion; Medical diagnosis; Medical treatment; Original; Original Article; Pleura; Pleural effusions; pleural fluid cytology; Tuberculosis; India; malignant pleural effusion; Closed pleural biopsy; pleural fluid cytology
• ISSN: 0974-2727; 0974-7826
• DOI: 10.4103/0974-2727.98669

ABSTRACT Background: Pleural fluid cytology for malignant cells is the easiest way to diagnose malignant pleural effusion with good sensitivity and specificity. With the introduction of medical thoracoscopy, the use of closed pleural biopsy for the diagnosis of cytology negative malignant pleural effusion is gradually decreasing. However use of thoracoscopy is limited due to its high cost and procedure related complications. Aims: The aim was to assess the usefulness of closed pleural biopsy in the diagnosis of malignant pleural effusion. Materials and Methods: Sixty-six patients of pleural effusion associated with malignancy were selected from the patients admitted in the chest ward of a tertiary care hospital over a period of 1 year. Pleural fluid aspiration for cytology and closed pleural biopsy were done in all the patients. Results: Out of 66 patients, 46 (69%) patients showed malignant cells in pleural fluid cytology examination. Cytology was positive in 35 (52%), 10 (15%), and 1 (1.5%) patients in the first, second, and third samples respectively. Closed pleural biopsy was positive in 32 (48%) patients. Among them, 22 also had positive cytology. Additional 10 cytology negative patients were diagnosed by pleural biopsy. Cytology–histology concordance was seen in 12 patients. Definite histological diagnosis could be achieved in five patients with indeterminate cytology. Pleural biopsy was not associated with any major postoperative complication. Conclusion: Closed pleural biopsy can improve the diagnostic ability in cytology negative malignant pleural effusion. Closed pleural biopsy has still a place in evaluation of malignant pleural effusion especially in a resource-limited country like India.