scholarly journals Clinical and Epidemiological Features of Tuberculous Pleural Effusion in Alicante, Spain

2021 ◽  
Vol 10 (19) ◽  
pp. 4392
Author(s):  
Eusebi Chiner ◽  
Miriam Nomdedeu ◽  
Sandra Vañes ◽  
Esther Pastor ◽  
Violeta Esteban ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Diagnostic Techniques ◽  
Acute Onset ◽  
Pleural Biopsy ◽  
Tuberculous Pleural Effusion ◽  
Radiological Features ◽  
Epidemiological Features ◽  
Previous Contact

We aimed to (1) evaluate the incidence of tuberculous pleural effusion (TPE) over 25 years in our centre; (2) measure the yield of different diagnostic techniques; (3) compare TPE features between immigrant and native patients. Retrospective study of patients who underwent diagnostic thoracentesis and pleural biopsy in our hospital between 1995 and 2020. TPE was diagnosed in 71 patients (65% natives, 35% immigrants). Onset was acute in 35%, subacute in 26% and prolonged in 39%. Radiological features were atypical in 42%. Thoracentesis specimens were lymphocyte-predominant in 84.5% of patients, with elevated adenosine deaminase in 75% of patients. Diagnostic yield of pleural biopsy was 78%. Compared with native patients, more immigrants had previous contact with TB (54% vs. 17%, p = 0.001), prior TB (21% vs. 4%, p < 0.02) and atypical radiological features (58% vs. 34%, p < 0.03). TPE incidence was six times higher in the immigrant population (6.7 vs. 1.1 per 100,000 person-years, p < 0.001). TPE has an acute onset and sometimes atypical radiological features. Pleural biopsy has the highest diagnostic yield. Reactivation, prior contact with TB, atypical radiological features, complications, and positive microbiology results are more common in immigrant patients.

scholarly journals Diagnostic Value of Flexible Thoracoscopy in Undiagnosed Cases of Exudative Pleural Effusion

2020 ◽  
Vol 7 (47) ◽  
pp. 2783-2786
Author(s):  
Vengada Krishnaraj S.P. ◽  
Gayathri S. Mohan ◽  
Vinod Kumar V ◽  
Sridhar R
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Complete Blood Count ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Parietal Pleura ◽  
Pleural Biopsy ◽  
Cardiac Evaluation ◽  
Exudative Pleural Effusion ◽  
Fluid Cytology

BACKGROUND The diagnostic yield of thoracoscopy is 95 %, of pleural fluid cytology it is 62 % and of closed pleural biopsy is 44 %, in malignant effusion. We wanted to study the diagnostic utility of flexible thoracoscopy in undiagnosed exudative pleural effusion and compare the thoracoscopy findings with the histopathology results. METHODS The study was conducted in the Department of Respiratory Medicine, Government Stanley Medical College, Chennai, from January 2019 to January 2020. 40 patients were enrolled in this longitudinal observational study with moderate to massive effusion and were evaluated with pleural fluid aspiration and sent for cytology, protein sugar analysis, total count, and ADA. Those cases which are exudative pleural effusions, with ADA value of less than 40 IU / L were subjected to thoracoscopy after being evaluated for fitness for thoracoscopy with complete blood count, bleeding time, clotting time, sputum for AFB, ECG, pulse oximetry, cardiac evaluation and CT chest. RESULTS Thoracoscopy was done in 40 enrolled patients. In this study, biopsy was taken from the parietal pleura in all the cases. Of these 40 cases, 30 were male and 10 were female, that is 75 % males and 25 % females. The mean age of the study population was 43 ± 14.9. Patient with the lowest age in this study group was 18 years and highest was 71 years. 16 cases (40 %) presented with left sided pleural effusion. 24 cases (60 %) presented with right sided pleural effusion. 30 cases presented with massive effusion, and 10 cases with moderate effusion. Of the 40 cases, 27 cases presented with straw coloured pleural effusion. 13 cases were haemorrhagic effusion. Histopathologic examination showed 11 cases as malignant and 29 cases as non-malignant out of which 18 cases were of tuberculosis aetiology. Thoracoscopy revealed adhesions in 13 cases and mass lesion in 4 cases. Of the 4 mass lesions 3 came as malignant, normal pleura in 11 cases, 10 were non-malignant and 1 was malignant. Nodules were seen in 12 cases of which 7 came as malignant. Straw coloured effusion was seen in 27 cases, of which 2 were malignant. CONCLUSIONS The most important indication for thoracoscopy is exudative undiagnosed pleural effusion. The overall diagnostic yield in pleural fluid cytology is 62 % and blind pleural biopsy is 44 %. The diagnostic yield of thoracoscopy varies from 60 % to 97 % in various studies, whereas, in our study, it is 72.5 %. Visualization of the visceral and parietal pleura is another advantage, so that we can take biopsy from the abnormal areas. KEYWORDS Flexible Thoracoscopy, Undiagnosed Exudative Pleural Effusion

scholarly journals The diagnostic yield of closed needle pleural biopsy in exudative pleural effusion: a retrospective 10-year study

2020 ◽  
Vol 8 (7) ◽  
pp. 491-491
Author(s):  
Tianli Zhang ◽  
Bing Wan ◽  
Li Wang ◽  
Chuling Li ◽  
Yangyang Xu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Pleural Biopsy ◽  
Exudative Pleural Effusion

scholarly journals DIAGNOSTIC YIELD OF ABRAMS PLEURAL BIOPSY IN PATIENTS PRESENTING WITH LYMPHOCYTIC EXUDATIVE PLEURAL EFFUSION.

2019 ◽  
Vol 26 (07) ◽  
pp. 1014-1019
Author(s):  
Kashif Sardar ◽  
Nasir Javed ◽  
Sufyan Saleem Safdar
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Definitive Diagnosis ◽  
Care Hospital ◽  
Pleural Biopsy ◽  
Cross Sectional ◽  
Medical Thoracoscopy ◽  
Exudative Pleural Effusion

Background: Pleural effusion is the one of the most common clinical conditions encountered in pulmonology clinics and the routinely performed tests on pleural fluid do not provide definitive diagnosis in majority of the cases. Medical thoracoscopy with pleural biopsy under direct vision of the abnormal area provides the highest diagnostic yield. Abrams closed needle pleural biopsy is a conventional and cheaper procedure which can help in the definitive diagosis in cases of undiagnosed pleural effusion. Objectives: To determine the diagnostic yield of abrams pleural biopsy in patients presenting with lymphocytic exudative pleural effusion. Study Design: Cross Sectional Study. Setting: Department of Pulmonology Nishtar Hospital Multan; Tertiary care hospital of 1180 beds. Period: Six months. Results: There were 145 patients diagnosed with lymphocytic exudative pleural effusion. Of these 145 study cases, males were 83/145 (57.2%) whereas females were 62/145 (42.8%). Mean age of our patients was 41.62 ± 13.63 years while mean duration of illness was 7.0 ± 3.24 weeks. When the frequencies of various diagnosis established on the basis of histopathology results obtained from the tissue specimen obtained with Abrams pleural biopsy was noted, Tuberculosis was the major cause of lymphocytic exudative pleural effusion as its frequency was noted to be in 81/145 (55.9%) of our patients while malignancy was present in 26/145 (17.9%) of our study cases whereas the histopathology turned out to be inconclusive in 38/145 (26.2%) showing non-specific inflammation. The diagnostic yield of Abrams pleural biopsy turned out to be 73.8% whereas it was unable to establish diagnosis in 26.2%. Conclusion: Abrams needle pleural biopsy is simple, reliable and safe method of diagnosis with a good diagnostic yield. Routine use of this procedure in patients with lymphocytic exudative pleural effusion can lead to a definitive diagnosis in majority of patients.

Impact of age on the diagnostic yield of four different biomarkers of tuberculous pleural effusion

Tuberculosis ◽  
2019 ◽  
Vol 114 ◽  
pp. 24-29 ◽  
Author(s):  
Piotr Korczynski ◽  
Joanna Klimiuk ◽  
Aleksandra Safianowska ◽  
Rafal Krenke
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Tuberculous Pleural Effusion

scholarly journals Modified thoracoscopic pleural cryo-biopsy in diagnosis of exudative pleural effusion of undetermined etiology

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ayman Ibrahim Baess ◽  
Essam Gouda Hassanein ◽  
Mohamed Al Saeed Emara ◽  
Heba Ahmed Eshmawey
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Fat Cells ◽  
Modified Technique ◽  
Pleural Biopsy ◽  
Post Procedure ◽  
Standard Tool ◽  
Undetermined Etiology ◽  
Exudative Pleural Effusion

Abstract Background Rigid thoracoscopy is the gold standard tool for diagnosing exudative pleural effusion, but sometimes it is difficult to obtain sufficient biopsies using the conventional forceps. This study evaluated the efficacy, safety, and diagnostic value of a modified technique using cryoprobe to obtain pleural biopsies during thoracoscopy. Results This is a single-center prospective study in patients that underwent rigid thoracoscopy using conventional rigid forceps followed by a cryoprobe at the same setting after injection of subpleural mixture of adrenaline and xylocaine. Biopsies were reviewed by an independent pathologist; any complications were recorded, and all patients were followed-up post-procedure. Twenty-four patients (12 males; mean age was 56 ± 15.1years) were included. The diagnostic yield of both rigid forceps biopsy (RFB) and cryoprobe biopsy (CPB) was 100%. CPB had more surface area than RFB with no difference regarding largest diameter (p = 0.064). RFB and CPB had similar results regarding presence of fat cells. CPB had much less crushed cells than RFB with better tissue preservation (p = 0.004). No significant complications were reported. Conclusions The modified cryoprobe biopsy is a highly effective and safe way for obtaining pleural biopsy besides affording good quality and size of the biopsy especially in thick firmly adherent pleura.

scholarly journals Tuberculous Pleural Effusion Presenting with Prevertebral and Cervical Emphysema: An Unusual Presentation

2015 ◽  
Vol 7 (2) ◽  
pp. 83-84
Author(s):  
Ishwar Singh
Keyword(s):  
Pleural Effusion ◽  
Final Diagnosis ◽  
Acute Onset ◽  
Unusual Presentation ◽  
Retropharyngeal Space ◽  
Tuberculous Pleural Effusion ◽  
Space Infection ◽  
Anterior Aspect ◽  
Deep Neck Space Infection ◽  
Air Pockets

ABSTRACT We present a case of a 45-year-old male presenting with acute onset swelling on anterior aspect of neck, dysphagia and dyspnea. Clinical examination revealed bilateral submandibular space emphysema and retropharyngeal bulge. The preliminary diagnosis was made of an evolving deep neck space infection. Further, computed tomography (CT) of chest and neck was done which showed heterogenous collection in retropharyngeal space with air pockets and right-sided pleural effusion. Pleural tap was sent for cytology and adenosine deaminase (ADA) levels, which were found to be significantly raised. Thus, a final diagnosis of tuberculous pleural effusion was made and patient was started on anti-tubercular treatment. How to cite this article Chauhan A, Rajan S, Singh I. Tuberculous Pleural Effusion Presenting with Prevertebral and Cervical Emphysema: An Unusual Presentation. Int J Otorhinolaryngol Clin 2015;7(2):83-84.

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