Closed percutaneous pleural biopsy. A lost art in the new era.
OBJECTIVE
To assess the association between size and number of biopsy specimens obtained by percutaneous closed pleural biopsy, with overall diagnostic yield in general, and histopathological evidence of tuberculosis pleurisy, in particular.


METHODS
One hundred and forty-three patients, with a high index of clinically having tuberculous pleurisy, were referred to the respiratory division of Mubarak Al-Kabeer Hospital in Kuwait during a 9-year period (January 1999 to December 2007). All subjects with exudative lymphocytic predominant effusion underwent percutaneous closed pleural biopsy, looking for tuberculous granulomas. The clinical diagnosis and pathological characteristics (number and size of biopsy samples) were analyzed.


RESULTS
Overall diagnostic yield of percutaneous closed pleural biopsy in all cases was noticed to be 52%. The larger biopsy sample size of 3 mm and more, and the higher number of specimens (> or = 4) were significantly associated with an increased diagnostic yield for tuberculous pleurisy (p=0.007 and 0.047).


CONCLUSIONS
Obtaining 4 or more biopsy samples, and larger specimens of 3mm and more for histopathological evaluation, through percutaneous pleural biopsy, results in a better diagnostic yield for tuberculous pleurisy.
Khadadah
Mousa E
ME
Department of Medicine, Faculty of Medicine, Kuwait University, PO Box 15081, Al-Daeyah 35451, Kuwait. mkhadadah@yahoo.com
Muqim
Abdulaziz T
AT
Al-Mutairi
Abdulla D
AD
Nahar
Ibrahim K
IK
Sharma
Prem N
PN
Behbehani
Nasser H
NH
El-Maradni
Nabeel M
NM
D001706:Biopsy / Q000379:methods*; D006801:Humans; D010994:Pleura / Q000473:pathology*; D014396:Tuberculosis, Pleural / Q000175:diagnosis* / Q000473:pathology