Vnitr Lek 2014, 60(5-6):423-430

Closed pleural biopsy in the diagnostics of malignant pleural involvement

Petr Jakubec^1,*, Vítězslav Kolek¹, Aleš Václavík¹, Jaromír Zatloukal¹, Stanislav Losse¹, Ladislava Kučerová², Tomáš Tichý², Kateřina Musilová²

¹ Klinika plicních nemocí a tuberkulózy LF UP a FN Olomouc, přednosta prof. MUDr. Vítězslav Kolek, DrSc.

² Ústav klinické a molekulární patologie LF UP a FN Olomouc, přednosta prof. MUDr. Zdeněk Kolář, CSc.

Introduction:
Pleural effusion is a frequent reason for a pulmonologist's investigation. The cornerstone is to distinguish transudative pleural effusion from exudative pleural effusion. In the case of the exudative pleural effusion the next step is detection of malignant etiology of pleural effusion. We have a variety of any non-invasive or invasive examinations. The pleural biopsy is one of the most important methods for diagnostics of malignant pleural effusion.

Material and methods:
Two hundred and twenty-two closed pleural biopsies (CPB) were performed in 208 patients with pleural effusion, where the cytologic examination of pleural fluid was negative. The authors evaluated the value of CPB for the diagnosis of malignant pleural involvement.

Results and conclusion:
Total sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 63.1 %, 100 %, 73.9 %, 100 % and 52.8 %, but in the group of mesotheliomas these results were 59.1 %, 100 %, 79.4 %, 100 % and 70.7 %. The incidence of complications and representative sampling of the pleura was mentioned. The authors compared the diagnostic value and the incidence of complications of various diagnostic methods in malignant pleural involvement by data in the literature.

Keywords: closed pleural biopsy; diagnostic methods; histological diagnosis; malignant pleural involvement; pleural effusion

Received: November 20, 2013; Accepted: March 10, 2014; Published: May 1, 2014  Show citation