Diagnostic value of Pleural Biopsy in Exudative Pleural effusion

Background: Exudative pleural effusion is a common diagnostic problem. This study was conducted to find the diagnostic yield of pleural biopsy in exudative pleural effusion. Material & Methods: This descriptive study was conducted in Medical B unit, Khyber Teaching Hospital Peshawar, from January 2009 to December 2009. Cases were confirmed through history, clinical examination and routine investigations. Patients with pleural effusion were first subjected to pleural fluid aspiration. The standard criteria for exudative pleural effusion were used and pleural biopsy was performed in patients with exudative pleural effusion. Specimens were placed in 10% formalin and sent for histopathology. Results: Fifty patients fulfilled the inclusion criteria; 33(66%) male and 17(34%) female. Out of these, 45(90%) had adequate specimen while in 5(10%) the tissue was inadequate. Among the 45 cases with adequate specimen, 40(80%) had a positive yield whereas in 5(10%) the result was nonspecific inflammation. In 40 cases with positive yield, 27(67.5%) were found to be granulomatous inflammation, 10(25%) malignant and 3(7.5%) parapneumonic. The most common complication of pleural biopsy was pain at biopsy site experienced in 100% cases and 3(6%) patients had phenumothrax. Conclusion: Pleural biopsy is safe, minimally invasive procedure and has a high diagnostic yield in exudative pleural effusion.