title: The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates.
abstract: We assessed the utility of ultrasound to guide the selection of closed pleural biopsy technique and site and to assess the respective contributions of repeat thoracentesis and closed pleural biopsy in 100 consecutive patients with undiagnosed pleural exudates. Thoracentesis was more likely to be diagnostic in TB than malignancy (77.8% vs 31.0%, p<0.001). The addition of ultrasound-guided biopsy increased the combined yield for all diagnoses from 48.0% to 90.0% (p<0.001), for malignancy from 31.0% to 89.7% (p<0.001) and for TB from 77.8% to 88.9% (p=0.688). Our findings suggest that this minimally invasive approach has a high diagnostic yield.
authors.affiliation: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa.
authors.forename: Coenraad Frederik N
authors.initials: CF
authors.lastname: Koegelenberg
authors.affiliation: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa.
authors.forename: Elvis Malcom
authors.initials: EM
authors.lastname: Irusen
authors.affiliation: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa.
authors.forename: Florian
authors.initials: F
authors.lastname: von Groote-Bidlingmaier
authors.affiliation: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa.
authors.forename: Johannes Willem
authors.initials: JW
authors.lastname: Bruwer
authors.affiliation: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa.
authors.forename: Enas Mansour A
authors.initials: EM
authors.lastname: Batubara
authors.affiliation: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa Division of Medical Physiology, Department of Biomedical Sciences, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa.
authors.forename: Andreas Henri
authors.initials: AH
authors.lastname: Diacon
mesh_terms: D000328:Adult; D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D010996:Pleural Effusion / Q000382:microbiology* / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D000069258:Thoracentesis; D013906:Thoracoscopy
keywords: Lung Cancer; Pleural Disease; Tuberculosis