Title: Role of Medical Thoracoscopy Guided Pleural Biopsy in Diagnosis of Moderate to Massive Exudative Pleural Effusion
Authors: Adesh Kumar (MD), Aditya Kumar Gautam (MD), Ashish Kumar Gupta, Somnath Bhattacharya (MD), Prashant Yadav (MD), Suryakant (MD)
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.131
Abstract
Background: Now days medical thoracoscopy has grown interest in establishing the fact of having greater etiological diagnostic yield in exudative moderate to massive pleural effusions. Pleural biopsy under direct vision can be successfully and safely used for etiological diagnosis.
Objective: To evaluate the value of medical thoracoscopic guided parietal pleural biopsy in the etiological diagnosis of exudative moderate to massive pleural effusions at a rural tertiary care centre of north India.
Methods: The study was conducted upon 90 patients with exudative moderate to massive pleural effusion, who required intercostal drainage (ICD) for management. Exudative pleural effusions were also smear negative for acid fast bacilli (AFB) and malignant cytology. All such patients with consent and institutional ethical clearance were submitted for medical thoracoscopic guided pleural biopsy for etiological diagnosis based on histopathology.
Results: Thoracoscopic pleural specimens were diagnostic in 86 patients out of a total 90 patients (95.5%). Histopathological examination of thoracoscopic specimens revealed, Malignancy- in 31 cases (34.4%), Inflammatory 28 (31.11%), Tuberculosis in 25 patients (27.8%) and Sarcoidosis in two cases (2.22%). Four patients (4.4%) were still inconclusive on histopathology.
Conclusion: Medical thoracoscopic guided pleural biopsy has a good diagnostic yield and safety. Hence it should be put into practice by physicians after proper training.
Keywords: Medical Thoracoscopy, Pleural Biopsy, Pleural Effusion.
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Dr Aditya K. Gautam
Assistant Professor, Department of Respiratory Medicine, U.P. Medical University Of Medical Sciences, Saifai, Etawah, Uttar Pradesh -206130
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