title: Tru-cut needle pleural biopsy and cytology as the initial procedure in the evaluation of pleural effusion.
abstract: OBJECTIVE
  The evaluation of pleural effusion (PE) includes various techniques, including pleural biopsy (PB). Our aim was to study the diagnostic yield of Tru-Cut needle PB (TCPB) and to define clinical/radiological situations in which TCPB might be indicated as an initial procedure.
  
  
  METHODS
  Retrospective study of TCPB in a hospital centre (2010-2012). Cases of pleural lesions without effusion were excluded. Clinical and radiological variables, diagnostic yield, TCPB complications and factors associated with the diagnostic yield of the combination of TCPB and thoracocentesis as initial procedure were analysed.
  
  
  RESULTS
  One hundred and twenty-seven (127) TCPB were reviewed: 29.1% were cases of malignant PE and in 18.9% the cause of the PE could not be determined. The diagnostic yield of TCPB for tuberculosis was 76.5% (13/17) and 54% (20/37) for malignant PE. Complications occurred in 4.7% of the cases. In 72 patients with a final definitive diagnosis, TCPB was performed at the same time as the initial thoracocentesis. Diagnostic yield for the combination of TCPB/cytology as an initial technique was 43% (31/72) compared to 12.5% (9/72) for cytology only (p=0.01). The only predictive variable for the indication of TCBP as an initial technique was a PE volume>2/3 (P=.04).
  
  
  CONCLUSIONS
  TCPB is safe and provides an acceptable diagnostic yield, particularly when combined with simultaneous cytology in the evaluation of PE of various aetiologies. Radiological criteria may help guide the selection of patients who could benefit from this technique as an initial procedure combined with thoracocentesis.
authors.affiliation: Unidad de Técnicas Broncopleurales, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: Maribel
authors.initials: M
authors.lastname: Botana Rial
authors.affiliation: Unidad de Técnicas Broncopleurales, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Andrés
authors.initials: A
authors.lastname: Briones Gómez
authors.affiliation: Unidad de Técnicas Broncopleurales, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Ferrando Gabarda
authors.affiliation: Unidad de Técnicas Broncopleurales, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: José Fernando
authors.initials: JF
authors.lastname: Cifuentes Ruiz
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: María Juliana
authors.initials: MJ
authors.lastname: Guarín Corredor
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Manchego Frach
authors.affiliation: Unidad de Técnicas Broncopleurales, Hospital Universitario y Politécnico La Fe, Valencia, España. Electronic address: cases_enr@gva.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Cases Viedma
mesh_terms: D001707:Biopsy, Needle / Q000295:instrumentation; D003584:Cytological Techniques; D004867:Equipment Design; D006801:Humans; D009339:Needles; D019152:Paracentesis; D010996:Pleural Effusion / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
keywords: Aguja Tru-cut; Biopsia pleural; Derrame pleural; Diagnostic yield; Pleural biopsy; Pleural effusion; Rentabilidad diagnóstica; Tru-cut needle