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Rev Clin Esp. 2017 Oct;217(7):423-426. doi: 10.1016/j.rce.2017.02.016. Epub 2017 Apr 19.

The case against performing pleural biopsies for the aetiological diagnosis of exudates.

[Article in English, Spanish]

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Unidad de Medicina Pleural, Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Instituto de Investigación Biomédica de Lleida (IRBLleida), Fundación Dr. Pifarré, Lleida, España. Electronic address:


In most cases, the etiological diagnosis of pleural exudates does not require a pleural biopsy. However, when it is considered necessary, the biopsy should seldom be conducted using invasive methods such as thoracoscopy. Two paradigmatic examples are pleural tuberculosis and malignant effusions. In many centres, pleural fluid adenosine deaminase measurement has replaced closed pleural biopsies in the diagnosis of tuberculosis. Similarly, pathological and molecular studies on pleural fluid cell blocks or alternatively, image-guided pleural biopsies have drastically reduced the need for thoracoscopy.


Biopsia pleural; Derrame pleural; Derrame pleural maligno; Malignant pleural effusion; Pleural biopsy; Pleural effusion; Pleural tuberculosis; Thoracoscopy; Toracoscopia; Tuberculosis pleural


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