Biopsy of pleural thickenings with pocket size ultrasound device

Introduction:Pleural pathology diagnosis is based on the collection of cytological and histological samples. The use of image techniques is becoming more popular to increase accuracy and safety. TAC-guided thoracic biopsy is the most commonly used method but thoracic ultrasound offers some advantages like: absence of ionizing radiations and bedside exploration. Our aim was to analyze effectiveness and safety of the ultrasound-guided pleural biopsies using a pocket size ultrasound device (PSUD). Methods: A prospective, one-year study from January 2016 to January 2017 was carried out. We included all patients with pleural thickening greater than 3 mm. Pleural biopsy was performed with a 14G gauge automatic needle (Acecut. TSK). Biopsy was completely echo-guided. Results:The samples were tagged as adequate sample (AS) or non-adequate sample (NAS) depending on the presence of mesothelium evidenced by the pathologist. Adequate samples (AS) were also tagged as diagnostic samples (DAS) or non-diagnostic samples (NDAS). We enrolled 32 patients. 68.8% were males, mean age of 53 (ED: 31). Biopsy was performed without need of hospitalization in 50 % of the cases. We obtained 26 AS (84.4%). 96.4% of them were diagnostic (DAS). Only one case showed further evidence of pleural involvement in a negative biopsy (mediastinal pleura). The only complication in all the biopsies performed was a pneumothorax without clinical repercussion in a pleural nodule biopsy without pleural effusion. The patient was treated with a conservative approach. Conclusion:PSUD is a useful tool to increases effectiveness and safety of the histologic diagnosis of pleural thickening.