Chest

Chest

Volume 92, Issue 6, December 1987, Pages 1050-1052
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Pleural Biopsy with Cope and Abrams Needles

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The object of this study was to compare the diagnostic yield of Abrams and Cope needles. Pleural biopsies were performed in 24 patients with both needles. In two patients, the procedure was repeated within a few days. All patients had pleural effusion. The biopsies were performed at the same time; the biopsy sites were no more than 5 cm distant from each other. Diagnoses were exclusively pathologic. There was no difference between the needles in relation to diagnosis; greater size of the fragment, mesothelial cells, and fibrin were most frequently obtained by Abrams needle, while muscle was better obtained with the Cope needle. The biopsies with both needles were very similar regarding chronic inflammation, granuloma, caseous necrosis, neoplastic tissue, granulation, neutrophils, hemorrhage, vessels, nerves, adipose tissue and epidermis. The advantages of more pleural tissue obtained with the Abrams needle was not translated into better diagnostic yield in the present series.

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MATERIAL AND METHODS

After informed consent, 24 inhospital patients underwent, at the same time, pleural biopsy punctures with Cope and Abrams needles. The punctured sites were next to each other, being, at the utmost, 5 cm from each other. In two patients, the procedures were performed twice, with a few days' interval. The operator was always the same (E.A.), and had previous experience with both needles.

All patients showed pleural, effusion and the procedures were performed under local anesthesia with 2 percent

RESULTS

On two occasions (once with each needle), pleura was not identified.

The neoplasm, tuberculosis, acute pleuritis, or chronic inflammation diagnosis was established respectively in nine, three, eight, and six procedures.

Table 1 shows that the diagnosis performance of both needles has been the same. They were coincident in 18 cases. Table 2 analyzes the elements commonly described in pleural biopsies; note that, in general, their main richness is similarly distributed among the biopsies performed

DISCUSSION

Comparability of pleural biopsy specimens obtained with Cope and Abrams needles can be precisely determined if they are performed in the same patients, at the same time and next to each other.

In spite of our efforts, we were not able to identify any article on this methodology, so we believe this is the first to utilize it.

The comparative method employed has been the semiquantitative one which, although not ideal, is considered to be sufficiently precise to allow us to draw some conclusions

ACKNOWLEDGMENTS

The authors are indebted to Miss Esmene Comenale for her help in translating this paper.

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There are more references available in the full text version of this article.

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Manuscript received January 26; revision accepted May 18.

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Copyright © 1987 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.