CT-guided biopsy versus conventional Abram’s needle biopsy in malignant pleural effusion

ObjectiveWe aimed to evaluate CT guided biopsy (CTGB) vs. standard closed pleural biopsy (CPB) in the histopathological diagnosis of the type of malignancy in patients with malignant pleural effusion.Patients and methodsWe studied 31 patients (21 male and 10 female) with malignant pleural effusion diagnosed by aspiration cytology and admitted to the medical ward of a general teaching hospital over a period of 1 year. Patients were randomized into two groups: group 1 (n = 16) underwent CTGB biopsy and group 2 (n = 15) underwent Abram’s CPB. The diagnostic yield of both methods was compared.ResultsThe mean age of patients was 54 ± 16 years. History of smoking was obtained in 15 (48.4%) patients. Dyspnea was reported in 22 (71%) and chest pain in 15 (48.4%). Malignant pleural effusion was left-sided in 17 (54.8%), and massive in 21 (67.7%) patients. Of note, CT imaging revealed parietal pleura as a tumor site in 20 (64.5%) patients. Pathological diagnosis of the type of malignancy was achieved in 14 (87.5%) of group 1 using CTGB and 6 (40%) of group 2 patients using Abram’s CPB. The diagnostic value of CTGB was significantly higher than CPB (P = 0.009).ConclusionCT-guided biopsy was found to be a reliable and safe method in the histopathological diagnosis of malignant pleural effusion. Its diagnostic potential was much superior to the standard closed pleural biopsy.