Comparison between ultrasound-guided Abrams needle and medical thoracoscopic pleural biopsies in exudative pleural effusion

Abstract

Background The actual diagnosis of pleural disease (especially for malignancy) depends on the histopathological finding obtained through pleural biopsy or positive pleural fluid cytology result. Pleural tissue biopsies can be obtained by several methods: blind, image-guided, thoracoscopic, or open surgical pleural biopsies. The diagnostic yield of image-guided sampling is increased owing to the ability to precisely target an abnormal area of the pleura. Aim The aim of this work was to compare between ultrasound-guided Abrams needle and medical thoracoscopic pleural biopsies (MT-PB) in exudative pleural effusion and see the diagnostic yield of ultrasound-guided pleural biopsy. Patients and methods This study included 40 patients with exudative pleural effusion admitted to Chest Department, Menoufia University Hospital, during the period from August 2015 to November 2017. All had pleural thickening in contrast-enhanced thoracic computed tomography scan. All patients underwent ultrasound-guided Abrams’ needle followed by MT-PB. Results Compared with MT-PB, the sensitivity and specificity of ultrasound-guided Abrams needle pleural biopsy were 81.58 and 100%, respectively. No difference was identified between the yields of the two methods. Conclusion Ultrasound-guided Abrams needle pleural biopsy considers an alternative to medical thoracoscopy in exudative pleural effusions associated with pleural thickening.