[Pleural puncture biopsy in the aetiological diagnosis of pleurisy].

INTRODUCTION

Pleurisy represents a worrying situation because of the difficulty of aetiological diagnosis. The aim of this study was to evaluate the contribution of pleural puncture biopsy (PPB) in the diagnosis of pleurisy.

METHODS

A prospective study of the contribution of the pleural puncture biopsy in the pulmonary service of Bamako (Mali) from 2005 to 2009. PPB was used in the investigation of exudative, non-purulent pleurisy of unknown aetiology. Castelin biopsy forceps were used.

RESULTS

Pleurisy was the reason for 20% of the total admissions of 6374 patients. The PPB was performed in 390 patients or 30.6% of the cases of pleurisy. The HIV test was performed in 341 patients (87.4%), of whom 72 cases (21.1%) were positive. The pleural biopsies were: lymphocytic (68.7%), mixed cellular (17.1%). Histological interpretation was possible in 367 biopsy specimens, a yield of 94.1%. Tuberculous granulomata were found in 65.1% with a close relationship to HIV status (P<0.004). Pleural cancer was found in 16.1%.

CONCLUSION

The PPB is easy to perform at a low cost. It permits the diagnosis of tuberculous and neoplastic pleurisy, particularly in low income countries with a high prevalence of TB/HIV.