Exudative pleural effusions: Comparative study of image assisted Abram needle pleural biopsy and medical thoracoscopy

BackgroundPleural tissue can be harvested either by means of closed biopsies, thoracoscopy or open surgical biopsies. Access to thoracoscopy and open surgical biopsies is limited in many parts of the world and closed biopsies are therefore the preferred initial investigation (Diacon et al., 2003) [6].Aim of the studyThis study aimed to compare the diagnostic efficiency of image-assisted ANPB with that of medical thoracoscopy in patients with exudative pleural effusion.Patients and methodsForty patients with non-diagnosed exudative pleural effusions were recruited. All had a contrast-enhanced thoracic CT scan to assess pleural thickening. Patients were randomly stratified by baseline pleural thickening, to either image-assisted Abrams’ pleural biopsy (n = 20) or medical thoracoscopy biopsy (n = 20).ResultsDiagnostic sensitivity of image-assisted ANPB for 20 patients (group I) was 75% (15/20), for group Ia was 60% (6/10), and for group Ib was 90% (9/10). Diagnostic sensitivity of thoracoscopy for 20 patients (group II) was 85% (17/20), for group IIa was 80% (8/10), and for group IIb was 90% (9/10).ConclusionsImage-assisted Abram-needle pleural biopsy is a primary alternative to thoracoscopy in exudative pleural effusions associated with pleural thickening.