• Govind Singh Rajawat, Supreet Batra, Rajendra Prasad Takhar, Lalit Rathi, Chand Bhandari, and Manohar Lal Gupta.
• Department of Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, India.
• Avicenna J Med. 2017 Jul 1; 7 (3): 121-124.

BackgroundClosed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups.ObjectiveThe objective of this study was to analyze the diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion and assessment of patients' characteristics with the yield of pleural biopsy.DesignThis was a cross-sectional study.SettingsThis study was conducted at Institute of Respiratory Diseases, SMS Medical College, Jaipur, a tertiary care center of West India.Patients And MethodsA total of 250 cases of pleural effusion were evaluated with complete pleural fluid biochemical, microbiological, and cytological examination. Out of these 250 patients, 59 were excluded from the study as the diagnosis could be established on initial pleural fluid examination. The remaining (191) patients were considered for closed pleural biopsy with Abrams pleural biopsy needle.Main Outcome MeasuresThe main outcome measure was diagnostic yield in the form of confirming diagnosis.ResultsOut of the 191 patients with exudative lymphocytic pleural effusion, 123 (64.40%) were diagnosed on the first pleural biopsy. Among the remaining 68 patients, 22 patients had repeat pleural biopsy with a diagnostic yield of 59.9%. The overall pleural biopsy could establish the diagnosis in 136 (71.20%) patients with pleural effusion. The most common diagnosis on pleural biopsy was malignancy followed by tuberculosis.ConclusionsClosed pleural biopsy provides diagnostic yield nearly comparative to thoracoscopy in properly selected patients of pleural effusions. In view of good yield, low cost, easy availability, and very low complication rate, it should be used routinely in all cases of undiagnosed exudative lymphocytic pleural effusion.LimitationsThere was no comparison with a similar group undergoing thoracoscopic pleural biopsy.

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