Ultrasound guided needle pleural biopsy in patients with undiagnosed pleural effusion

Background: Cases of pleural effusion represent a great challenge for pulmonologists and ultrasound is considered as an important tool for diagnosis of these cases. Aim: To identify the role of percutaneous ultrasound guided needle biopsy in patients with undiagnosed pleural effusion. Patients and methods: This study was conducted on 30 patients (26 males & 4 females) with undiagnosed pleural effusion using ultrasound guided pleural biopsies using tru-cut needle. Diagnostic yield, pathological tissue characterization, complications were recorded. Results: The total number of diagnosed cases was 24 (80%); malignancies detected in 17 cases (9 as mesothelioma (30%), 8 as bronchogenic carcinoma with pleural metastasis (26.7%)), tuberculous effusion in 2 cases (6.7%), inflammatory lung masses in 3 cases (10%), para-pneumonic effusion in 2 cases 6.7%) and 6 cases were not diagnosed (20%). In diagnosed casestissues were classified according to pathological characterization into pleural tissue in 4 cases (16.7%), pleural mass tissue in 8 cases (33.3%), mixed pleural tissue and pleural mass tissue in 2 cases (8.3%) and mixed pleural tissue with pleural and parenchymal mass tissue in 10 cases (41.7%). Complications were in the form of bleeding at the site of procedure in 1 case(3.3%), shock in 1 case (3.3%) and pneumothorax in 2 cases (6.7%). Sensitivity, specificity and accuracy of ultrasound guided pleural biopsy were 80, 76 and 80% respectively. Conclusions: Ultrasound-guided pleural biopsy is an effective and safe technique in patients with undiagnosed pleural effusion. It allows accurate needle placement, shorter procedure time.