The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates

Thorax. 2015 Oct;70(10):995-7. doi: 10.1136/thoraxjnl-2014-206567. Epub 2015 May 21.

Abstract

We assessed the utility of ultrasound to guide the selection of closed pleural biopsy technique and site and to assess the respective contributions of repeat thoracentesis and closed pleural biopsy in 100 consecutive patients with undiagnosed pleural exudates. Thoracentesis was more likely to be diagnostic in TB than malignancy (77.8% vs 31.0%, p<0.001). The addition of ultrasound-guided biopsy increased the combined yield for all diagnoses from 48.0% to 90.0% (p<0.001), for malignancy from 31.0% to 89.7% (p<0.001) and for TB from 77.8% to 88.9% (p=0.688). Our findings suggest that this minimally invasive approach has a high diagnostic yield.

Keywords: Lung Cancer; Pleural Disease; Tuberculosis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration*
  • Exudates and Transudates
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pleura / pathology*
  • Pleural Effusion / microbiology*
  • Pleural Effusion / pathology*
  • Prospective Studies
  • Sensitivity and Specificity
  • Thoracentesis*
  • Thoracoscopy