Malignant Pleural Effusion: A Continued Relevance of Closed Needle Pleural Biopsy

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dc.contributor.authorGupta, Aen_US
dc.contributor.authorDesai, Uen_US
dc.contributor.authorJoshi, JM.en_US
dc.date.accessioned2023-08-09T06:06:29Z
dc.date.available2023-08-09T06:06:29Z
dc.date.issued2022-12
dc.description.abstractIntroduction: Thoracocentesis and pleural biopsy are recommended for the evaluation of undiagnosed exudative pleural effusion. There are multiple etiologies associated with them, out of which malignancy is one of them. Hence, the diagnosis of malignant pleural effusion (MPE) has been proposed in recent perspectives. We aimed to find the profile of MPE, efficacy of percutaneous closed needle pleural biopsy (PCNPB) in diagnosing MPE, overall yield, and complication rate to evaluate the continued relevance of this traditional procedure. Methods: This was a prospective study carried out on consecutive consenting patients at the Department of Pulmonary Medicine at a tertiary care hospital from July 2016 to May 2018. The diagnosis was based on cytobiochemical, microbiological, and histopathological results along with clinical history. Data were analyzed with respect to pleural fluid assessment in terms of cytobiochemical and microbiological evaluation; while pleural biopsy was studied histopathologically. Results: Two hundred and fifty patients with exudative pleural effusion were enrolled. Tuberculosis (218, 87.2%) was the most common etiology followed by malignancy (22, 8.8%). The most common presenting complaint was chest pain (100%) followed by dyspnea (90.47%). Metastatic adenocarcinoma was found in 81.81% followed by mesothelioma in 18.18%. The sensitivity of pleural biopsy for malignancy was found to be 63.63% (p < 0.003, odds ratio [OR]: 2.01), and those fulfilling Leung's criteria, sensitivity was found to be 90.90% (p < 0.001, OR: 3.67). The sensitivity of pleural fluid for malignancy was 18.18% (p < 0.05, OR: 1.51). All cases of mesothelioma have asbestos exposure. The complication in the form of mild post-pleural biopsy pain was encountered in 10%, which required mild analgesics. Other complications in the form of self-resolving pneumothorax were seen in 6%, which increased hospital stay to 2�days and self-resolving hematoma (3%). Conclusion: In this modern era, PCNPB still holds high sensitivity, efficacy rate, and relevance for diagnosing MPE with less complication rate, less hospital stay, and can be done on a daycare basis. Also, we have very less research and paperwork regarding this topic.en_US
dc.identifier.affiliationsDepartment of Pulmonary Medicine, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Indiaen_US
dc.identifier.citationGupta A, Desai U, Joshi JM.. Malignant Pleural Effusion: A Continued Relevance of Closed Needle Pleural Biopsy. Indian Journal of Chest Diseases & Allied Sciences. 2022 Dec; 64(4): 288-291en_US
dc.identifier.issn0377-9343
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/221842
dc.languageenen_US
dc.publisherJaypee Brothers Medical Publishers Pvt. Ltden_US
dc.relation.issuenumber4en_US
dc.relation.volume64en_US
dc.source.urihttps://doi.org/10.5005/jp-journals-11007-0037en_US
dc.subjectMalignant pleural effusionen_US
dc.subjectMesotheliomaen_US
dc.subjectMetastatic adenocarcinomaen_US
dc.subjectPercutaneous closed needle pleural biopsyen_US
dc.titleMalignant Pleural Effusion: A Continued Relevance of Closed Needle Pleural Biopsyen_US
dc.typeJournal Articleen_US
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