Tru-Cut Needle Pleural Biopsy and Cytology As the Initial Procedure in the Evaluation of Pleural Effusion

Autores de IIS La Fe

• Andrés Brionés Gómez

  Autor

• Jose Fernando Cifuentes Ruiz

  Autor

• María Juliana Guarin Corredor

  Autor

• Enrique Cases Viedma

  Autor

Participantes ajenos a IIS La Fe

• Botana Rial M
• Ferrando Gabarda JR
• Manchego Frach N

Grupos

• Infecciones Respiratorias

  Investigador Principal

  Raúl Méndez Ocaña

• Neumología

  

  Leader

  Miguel Ángel Martínez García

Abstract

Introduction and objectives: The evaluation of pleural effusion (PE) includes various techniques, including pleural biopsy (PB). Our aim was to study the diagnostic yield of Tru-Cut needle PB (TCPB) and to define clinical/radiological situations in which TCPB might be indicated as an initial procedure. Methodology: Retrospective study of TCPB in a hospital centre (2010-2012). Cases of pleural lesions without effusion were excluded. Clinical and radiological variables, diagnostic yield, TCPB complications and factors associated with the diagnostic yield of the combination of TCPB and thoracocentesis as initial procedure were analysed. Results: One hundred and twenty-seven (127) TCPB were reviewed: 29.1% were cases of malignant PE and in 18.9% the cause of the PE could not be determined. The diagnostic yield of TCPB for tuberculosis was 76.5% (13/17) and 54% (20/37) for malignant PE. Complications occurred in 4.7% of the cases. In 72 patients with a final definitive diagnosis, TCPB was performed at the same time as the initial thoracocentesis. Diagnostic yield for-the combination of TCPB/cytology as an initial technique was 43% (31/72) compared to 12.5% (9/72) for cytology only (p = 0.01). The only predictive variable for the indication of TCBP as an initial technique was a PE volume > 2/3 (P =.04). Conclusions: TCPB is safe and provides an acceptable diagnostic yield, particularly when combined with simultaneous cytology in the evaluation of PE of various aetiologies. Radiological criteria may help guide the selection of patients who could benefit from this technique as an initial procedure combined with thoracocentesis. (C) 2013 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.

Keywords

• Pleural biopsy; Tru-cut needle; Diagnostic yield; Pleural effusion