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Diagnostic contribution of repeated thoracentesis and closed pleural needle biopsy in tuberculous pleurisy
Author(s) -
Cermik Hakan,
Demirer Ersin,
Kunter Erdogan,
Kartaloglu Zafer,
Kaya Hatice
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a405-d
Subject(s) - medicine , thoracentesis , pleurisy , sputum , biopsy , pleural effusion , pleural fluid , effusion , etiology , gastroenterology , tuberculosis , radiology , surgery , pathology
The use of all kinds of clinical, histopathological and biochemical examinations can not reveal the etiology of pleural effusion in 20 % of the cases. Diagnostic difficulties also apply to tuberculous pleurisy (TP). The aim of our study is to investigate the diagnostic contribution of insistive use of less invasive methods. 119 cases, age of 18–45 (24.05 ±5.76), with the prediagnosis of TP, to whom thoracentesis (T) and closed pleural needle biopsy (PB) were performed, were enrolled. First PB revealed; 4 (3.4 %) acute pleuritis (AP), 37 (31.1 %) chronic pleuritis (CP), 78 (73.1 %) granulomatous pleuritis (GP). All cases with AP were performed a second PB and; 3 GP, 1 CP were obtained. When a second PB performed in cases with an initial diagnosis of CP; 1 unsuccessful biopsy, 6 GP, 7 CP were reported. 78 cases (65.5 %) were consistent with TP in the first PB, and 9 more cases (73.1 %) with repeated PB. T was performed once in 79 (66.3 %) and twice in 40 cases (33.7 %). First T resulted in 12 (15.2 %) and second T resulted in another 7 (17.5 %) culture positivity. The rate of diagnosis of TP rised to 76.5 % with the microbiological examinations of pleural fluid and tissue. None of the second T and PB interventions caused complication. All cases were also examined for sputum smear. Together with the detection of tuberculous bacillus in the sputum diagnostic rate was 84 %. In conclusion, we suggest that in cases without a diagnosis at the first attempt, diagnosis would be reached in most of the cases with the repeat of the microbiological and/or pathological examinations of sputum, pleural fluid, PB specimens, and also unnecessary further invasive investigations could be avoided.