Abstract

Background: Exudative pleural effusion often requires detailed investigations which include cytology, biochemical and microbial examinations. However, in some cases the diagnosis may remain elusive they are labeled as undiagnosed exudative pleural effusion. We in the current study tried to evaluate the etiological diagnosis of exudative pleural effusion by pleural biopsy.
Methods: This cross-sectional study was conducted in the Department of Pulmonology, Rajiv Gandhi Institute of Medical Sciences, Adilabad. Thoracocentesis was done and pleural fluid was sent for cytological examination, biochemical, examination, and microbiological profile assessment to determine the cause of the effusion. The undiagnosed cases of exudative pleural effusion were subjected to pleural biopsy.
Results: A total of n=45 cases of the pleural biopsy were included in this study. The gross appearance of the pleural fluid in cases was straw-colored in 100% of cases of tuberculosis and hemorrhagic in 75% of cases of malignancy. The diagnosis of tuberculosis and malignancy was made in 17.77% of cases each. The mean LDH values were 856 ± 210.36 vs 482.98 ± 115.66 p values were 0.012 considered significant. The ADA values were 40.36 ± 2.9 vs 18.44 ± 3.1 p=0.021 were considered significant.
Conclusion: Pleural biopsy when done in cases where thoracocentesis and cytological examination, biochemical, examination, and microbiological profile assessment failed to determine the cause of the effusion is a useful procedure. It may be used when facilities of thoracoscopy and imaging-guided cutting needle biopsies are not available.