Medical thoracoscopy- Comparison of pleural biopsy, imprint cytology and cytology of pleural effusion

Abstract

It should be clarified if the imprint cytology of throacoscopic biopsies can be used for onsite cytological evaluation and i fit is ueseful to improve the diagnostic yield.

Impression samples were taken from each thoracoscopic biopsy.

A comparison of histology, imintint cytology and pleural effusion cytology was performed.

The final diagnosis was made during the course of the disease to check for false positives or false negatives.

From 7/2011 to 6/2015 an imprint preparation was made in 200 cases of pleural biopies. In 179 cases there was a simultaneous pleural effusion, which was also examined cytologically.

Results: Pleural effusion cytology (n: 179) had a sensitivity of 87.7%, a specificity of 97.6%, a positive predictive value of 96%, and a negative predictive value of 85%. For the imprint cytology (n: 200), a sensitivity of 98%, a specificity of 98.98%, a positive predictive value of 99% and a negative predictive value of 96% were found. For histology (n: 200) the sensitivity was 92%, the specificity 100%, the positive predictive value 100% and the negative predictive value 91.4%. The combination of imprint cytology and histology (n: 200) yielded a sensitivity of 96.3%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 96%.

Conclusion: Thoracoscopic biopsy is the gold standard for the diagnosis of pleural processes. By making imprint preparations of thoracoscopic biopsies, the diagnostic result can be further improved. This method is also appropriate for rapid onsite evaluation. Pleural effusion cytology is a powerful method.