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Audit, research and guideline update
The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates
  1. Coenraad Frederik N Koegelenberg1,
  2. Elvis Malcom Irusen1,
  3. Florian von Groote-Bidlingmaier1,
  4. Johannes Willem Bruwer1,
  5. Enas Mansour A Batubara1,
  6. Andreas Henri Diacon1,2
  1. 1Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa
  2. 2Division of Medical Physiology, Department of Biomedical Sciences, Stellenbosch University & Tygerberg Academic Hospital, Cape Town, South Africa
  1. Correspondence to Dr Coenraad FN Koegelenberg, Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, PO Box 241, Cape Town 8000, South Africa; coeniefn{at}sun.ac.za

Abstract

We assessed the utility of ultrasound to guide the selection of closed pleural biopsy technique and site and to assess the respective contributions of repeat thoracentesis and closed pleural biopsy in 100 consecutive patients with undiagnosed pleural exudates. Thoracentesis was more likely to be diagnostic in TB than malignancy (77.8% vs 31.0%, p<0.001). The addition of ultrasound-guided biopsy increased the combined yield for all diagnoses from 48.0% to 90.0% (p<0.001), for malignancy from 31.0% to 89.7% (p<0.001) and for TB from 77.8% to 88.9% (p=0.688). Our findings suggest that this minimally invasive approach has a high diagnostic yield.

  • Pleural Disease
  • Lung Cancer
  • Tuberculosis

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