Gökay GÜNGÖR, Emine AKSOY, Emin MADEN, Güliz ATAÇ, Tülin SEVİM, Kemal TAHAOĞLU, Tülay TÖRÜN

Diagnostic yield of closed pleural brushing

Bu çalışmada kapalı plevra fırçalaması (KPF)’nın malign plevral efüzyonlu hastalarda tanı değerinin araştırılması amaçlandı. Prospektif olarak yapılan çalışmaya yaş ortalaması 62.9 ± 8.6 olan 21 erişkin hasta (20 erkek ve 1 kadın) alındı. Her hastaya torasentez, KPF, plevral fırçalamayı takiben kapalı plevra biyopsisi (KPB) uygulandı. KPF 21 olgunun 12(%57.1)’sinde tanı sağlarken bu 12 olgunun 3’ünde plevra sıvı sitolojisi (PSS) ve KPB negatifti. PSS, KPF ve KPB’nin malign efüzyon tanısında sensitiviteleri sırasıyla %33, %57, %52 olarak hesaplandı. Üç girişim birlikte kullanıldığında sensitivite%67’ye yükseldi. KPF, KPB ve PSS’ye ek olarak uygulandığında tanı değerini %14 artırdı. Bu girişimlere bağlı bir mortalite izlenmedi. Üç (%14.2) olguda göğüs ağrısı, 2 (%9.5) olguda hipotansiyon, 1 (%4.8) olguda öksürük, 1 (%4.8) olguda pnömotoraks ve 1 (%4.8) olguda hemotoraks gelişti. Sonuç olarak, KPF güvenli, basit ve iyi tolere edilebilen bir tanısal girişim olarak malign plevral efüzyonlu hastalarda yüksek tanı oranı sağlar.

Kapalı plevra fırçalamasının tanı değeri

The aim of this study was to assess the diagnostic yield of closed pleural brushing (CPBR) in the diagnosis of malignant pleural effusion. Twenty-one adult patients (20 men and 1 woman); aged 62.9 ± 8.6 were participated to this prospective study. Thoracentesis, CPBR and closed pleural biopsy (CPB) following the brushing were applied to every patient. While CPBR provided diagnosis in 12 (57.1%) of 21 cases, in 3 of these 12 cases, pleural fluid cytology (PFC) and CPB were negative. The sensitivities of PFC, CPBR and CPB in the diagnosis of malignant effusions were 33%, 57% and 52%, respectively. When three procedures were used in combination, the sensitivity increased to 67%. When CPBR is performed in addition to PFC and CPB, the yield of the diagnosis increased 14% additionally. There was no mortality due to these interventions. Complications were chest pain in 3 (14.2%) cases, hypotension in 2 (9.5%) cases, cough in 1 (4.8%) case, pneumothorax in1 (4.8%) case, and hemothorax in 1 (4.8%) case. In conclusion, CPBR as a safe, simple and well tolerated procedure provide shigh diagnostic yield in diagnosis of patients with malignant pleural effusion.

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