Abstract
Until now the diagnostic yield of ultrasound guided pleural brushing for malignant pleural effusion is not evaluated. The aim of this study was to assess the diagnostic yield of this procedure and its contributions to obtain pleural specimen for cytological examination in malignant effusion.
Patients with suspicious malignant pleural effusion were hospitalized and enrolled in this study. Those with bleeding tendency or coagulation profile abnormalities were excluded from the study.
The tools used in our study were ultrasound apparatus, biopsy forceps, bronchoscopic cleaning brush, trocar and cannula of Cope's needle , rubber inlet seal and the semirigid thoracoscope . Thoracentesis, pleural brushing and biopsy forceps of the pleura were performed for all incorporated patients in the ultrasound unit while thoracoscopy was done in the endoscopy unit for only patients in whom the diagnosis could not be achieved by these procedures. Among 22 patients who were finally documented to have malignancy, the ultrasound guided pleural brushing provided diagnosis in 9 (41%) , it was exclusively diagnostic in 3 patients(13.6%). Interestingly, the yield of this procedure had its contributions regarding the final pathological diagnosis of our cases, it could augment the positive yield to be 55% instead of 41% (for pleural fluid cytology alone), 82% instead of 68% (for biopsy forceps alone) and 86% instead of 72% (for both fluid cytology and forceps biopsy). The recorded complications in our study were minimal and not associated with any mortality. Conclusions: Ultrasound-guided pleural brushing is a new method for obtaining pleural specimens. It is a simple and relatively safe procedure.
- Copyright ©the authors 2016
