Diagnostic utility of sonar guided biopsy in tuberculous effusion

Abstract

Background/aim: Tuberculous pleural effusion remains the commonest cause of exudative effusions in areas with a high prevalence of tuberculosis and histological examination of pleural tissue is the gold standard for its diagnosis. This study was to assess the diagnostic utility of sonar guided biopsy in tuberculous pleural effusion. Patients and methods: 50 patients (34 men) of mean ± SD age 38.7 ± 16.7 years with pleural effusions and a clinical suspicion of tuberculosis were enrolled in the study. Transthoracic ultrasound was performed on all patients, who were then randomly assigned to undergo ⩾4 Abrams needle biopsies followed by ⩾4 Tru-Cut needle biopsies or vice versa. Results: Pleural tuberculosis was diagnosed in 31 patients, alternative diagnoses were established in 16 patients and 3 remained undiagnosed. Pleural biopsy specimens obtained with Abrams needles contained pleural tissue in 29 patients (92.0%) and were diagnostic for tuberculosis in 26 patients (sensitivity 82%), whereas Tru-Cut needle biopsy specimens only contained pleural tissue in 21 patients (78%) and were diagnostic in 21 patients (sensitivity 64%). Conclusions: Ultrasound-assisted pleural biopsies performed with an Abrams needle are more likely to contain pleural tissue and have a significantly higher diagnostic sensitivity for pleural tuberculosis.

Keywords

• Tuberculous effusion
• Tru-Cut needle
• Abram’s needle