Ultrasound guided needle pleural biopsy in patients with undiagnosed pleural effusion

Abstract

BackgroundCases of pleural effusion represent a great challenge for pulmonologists and ultrasound is considered as an important tool for diagnosis of these cases. AimTo identify the role of percutaneous ultrasound guided needle biopsy in patients with undiagnosed pleural effusion. Patients and methodsThis study was conducted on 30 patients (26 males & 4 females) with undiagnosed pleural effusion using ultrasound guided pleural biopsies using a tru-cut needle. Diagnostic yield, pathological tissue characterization, complications were recorded. ResultsThe total number of diagnosed cases was 24 (80%); malignancies detected in 17 cases (9 as mesothelioma (30%), 8 as bronchogenic carcinoma with pleural metastasis (26.7%)), tuberculous effusion in 2 cases (6.7%), inflammatory lung masses in 3 cases (10%), para-pneumonic effusion in 2 cases (6.7%) and 6 cases were not diagnosed (20%). In diagnosed cases tissues were classified according to pathological characterization into pleural tissue in 4 cases (16.7%), pleural mass tissue in 8 cases (33.3%), mixed pleural tissue and pleural mass tissue in 2 cases (8.3%) and mixed pleural tissue with pleural and parenchymal mass tissue in 10 cases (41.7%). Complications were in the form of bleeding at the site of procedure in 1 case (3.3%), shock in 1 case (3.3%) and pneumothorax in 2 cases (6.7%). Sensitivity, specificity and accuracy of ultrasound guided pleural biopsy were 80, 76 and 80% respectively. ConclusionsUltrasound-guided pleural biopsy is an effective and safe technique in patients with undiagnosed pleural effusion. It allows accurate needle placement, shorter procedure time.