DIAGNOSTIC YEILD OF PLEURAL BIOPSY IN EXUDATIVE PLEURAL EFFUSION

Objective: To determine the diagnostic yield of pleural biopsy in exudative pleural effusion.Material and Methods: This prospective observational study comprising 50 patients ofexudative pleuraleffusion, was conducted in department ofMedicine, Hayatabad Medical complex{HMC}, Peshawar. Alwere included from the hospital OPD. Patients, who were having transudative pleural effusion and those, who were very emaciated, were excluded from the study History, clinical examination and baseline investigations like FBC, X-Ray chest PA view, Mantoux test, Renal functions and pleural fluid analysis were performed. Pleural biopsy was performed through Abramʹs pleural biopsy needle.Results: Out of50 patients, 33 were males and 17 were females. Regarding the presenting symptoms, 86%> presented with nonproductive cough, 66%presented with chest pain, 36% with breathlessness and44% with fever. In 45/50 (90%o) patients an adequate pleural tissue was obtained. Out of45 patients, 40 (89%) patients were having positive yield and 5 (11%) cases had nonspecific inflammation. Out of40 patients, 27 (67.5%) were having granulomatous inflammatory changes presumptive oftuberculosis, 10 (25%o) patients had malignancy and 3 (7.5%o) had miscellaneous conditions like Para pneumonic effusion etc. The most common complication was biopsy site pain in all cases. Only 3 (6%o) patients developed pneumothorax during the study period.Conclusion: Pleural biopsy has a high diagnostic yield. It is safe, simple and clearly differentiates between malignant and tuberculous effusions.