Comparison of Needle Biopsy With Cytologic Analysis for the Evaluation of Pleural Effusion: Analysis of 414 Cases
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MATERIAL AND METHODS
From 1973 through 1982, 1,644 patients underwent thoracenteses at the thoracic disease outpatient clinic of our institution. Among these patients were 414 who also underwent needle biopsy of the pleura, with either a Cope or an Abrams needle. Thirty of these patients underwent needle biopsy on two occasions; thus, a total of 444 biopsies were performed.
The case records of the 414 patients who underwent needle biopsy were reviewed in detail; clinical aspects, results of histologic examination of
RESULTS
Of the 414 patients who underwent pleural biopsies, 241 were men and 173 were women. Their average age was 59.6 years (range, 18 to 87 years). The initial diagnoses on the basis of the pleural biopsy alone were malignant disease in 123 patients (29.7%) and nonmalignant disease in 236 (57%). In 55 patients (13.3%), the needle biopsy failed to yield an adequate quantity of pleural tissue for analysis. The final etiologic diagnoses for the pleural effusions, established from clinical features or
DISCUSSION
This report includes more patients with malignant pleural effusion who underwent pleural biopsy than any previously published study of which we are aware. Cytologic analysis was positive for malignant disease in 58% of our patients; the highest positive rate (81%) was for pleural effusion due to metastatic breast carcinoma. Cytologic analysis of pleural fluid is reported to be diagnostic of malignant disease in 9% to 80% of cases, but in most series the success rate is about 60%.16, 17, 25, 33,
ACKNOWLEDGMENT
We are indebted to Dr. Leo F. Black for his invaluable suggestions in the preparation of this article and to Mr. Kenneth P. Offord for providing assistance with the statistical analysis. We gratefully acknowledge the help provided by Ms. Pamela J. Miller and Ms. Linda K. Smith in acquisition of data.
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