title: Yield of closed pleural biopsy and cytology in exudative pleural effusion.
abstract: OBJECTIVE
  To determine diagnostic yield of Closed Pleural Biopsy (CPB) and Cytology in Exudative Pleural Effusion (PE).
  
  
  METHODS
  This prospective comparative study was conducted at Chest Unit-II & Medical Unit-IV of Dow University of Health Sciences, Karachi Pakistan from January 2011 till December 2014.
  
  
  RESULTS
  Ninety-four patients with exudative PE were finally included. The mean age (SD) was 44.0 (13.8) years. Overall Specific Diagnosis was reached in 76/94 patients; 46 Tuberculosis PE (TPE) & 30 Malignant PE (MPE). CPB diagnosed all TPE patients alone and 28/30 of MPE. Cytology diagnosed only 10/30 patients of MPE with 8 patients having both CPB & Cytology positive for malignancy whereas in the remaining two cases only Cytology positive. The sensitivity of CPB in detecting TPE and MPE was 93.9% and 82.4% respectively whereas specificity for both was 100%. The diagnostic yield of cytology in detecting MPE is only (33.3%). The diagnostic yield of CPB for TPE and MPE is 100% and 93.3% respectively. The overall specific diagnostic yield of CPB is 78.7%.
  
  
  CONCLUSIONS
  CPB is better than pleural fluid cytology alone with the later adding little to diagnostic yield when both combined in distinguishing TPE from MPE, the two main differential of exudative PE in a TB-Endemic country.
authors.affiliation: Dr. Faisal Faiyaz Zuberi, FCPS (Medicine), FCPS (Pulmonology). Chest Unit-II, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Faisal Faiyaz
authors.initials: FF
authors.lastname: Zuberi
authors.affiliation: Prof. Bader Faiyaz Zuberi, FCPS. Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Bader Faiyaz
authors.initials: BF
authors.lastname: Zuberi
authors.affiliation: Dr. Syed Khalid Ali, MCPS. Chest Unit-II, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Syed Khalid
authors.initials: SK
authors.lastname: Ali
authors.affiliation: Dr. Sagheer Hussain, MBBS. Chest Unit-II, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Sagheer
authors.initials: S
authors.lastname: Hussain
authors.affiliation: Dr. Farhana Mumtaz, DTCD. Chest Unit-II, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Farhana
authors.initials: F
authors.lastname: Mumtaz
keywords: Abram’s needle; Lung cancer; Pleural Diseases; Sensitivity & Specificity