UTILITY OF BLIND PLEURAL BIOPSY IN UNDIAGNOSED PLEURAL EFFUSION USING ABRAMS NEEDLE
Journal of Evidence Based Medicine and Healthcare
BACKGROUND As many as one-fifth of all the exudative pleural effusions remain non-diagnostic, despite all the routine biochemical and cytological examinations of pleural fluid. The aim of the study is to examine the role of closed pleural biopsy using Abrams needle in such cases of pleural effusion in a tertiary care hospital of central India. MATERIALS AND METHODS All the patients with initial non-diagnostic pleural fluid thoracentesis from January 2017 to October 2017 were included in the
... included in the study and subjected to closed Abrams pleural biopsy. Biopsy sample was sent for histopathological examination, culture and CBNAAT (cartridge based nucleic acid amplification test) for tuberculosis. The patients who still remained nondiagnostic, further underwent other procedures as per the physician's decision. Statistical analysis was then done on the data collected. RESULTS Closed percutaneous pleural biopsy was performed in 60 patients. It yielded granulomatous inflammation suggestive of tuberculosis in 17 (28.33%), out of them, 15 cases were also detected by the CBNAAT. All of them were rifampicin sensitive. Malignancy was detected in 12 (20%) patients, mixed inflammatory pattern with pus cells in 9 (15%) patients. Almost, 22 samples (36.66%) were declared nondiagnostic. CONCLUSION Our age old closed biopsy technique was diagnostic in almost 64% cases of non-diagnostic pleural fluid exudates on thoracentesis. This study supports the use of Abrams needle for investigation purpose of pleural fluid in economically constrained countries.