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DIAGNOSTIC YIELD OF CYTOLOGY AND ABRAMS CLOSED PLEURAL BIOPSY IN LYMPHOCYTIC EXUDATE PLEURAL EFFUSIONS
*Ahmed Alhusein, Malek Hejazie and Zuheir Alshehabi
Objective: to evaluate the diagnostic yield and safety of Cytology and closed pleural biopsy in Lymphocytic exudate pleural effusions. Methods: This prospective cohort study was carried out in pulmonary and pathology departments at Tishreen university hospital, Lattakia, Syria between March 2020 and March 2021.The number of patients involved in this study is 49. Cytology is considered diagnostic when malignant cells are detected in the specimen of 50 ml Aspirate. Tuberculosis is diagnosed by the detecting caseating granulomas in tissue specimens obtained by closed pleural biopsy. Malignancy will be detected by observing malignant cells in pleural fluid or tissue samples obtained by closed pleural biopsy. Results: Cytology detected malignancy in 6 cases, and the other 43 cases were classified as negative. The overall diagnostic yield of cytology is very low (12.9%). Cytology sensitivity in malignancies is about 21.4%. Over all diagnostic yield of CPB were 68.75% CPB sensitivity in malignancies is 71.4 % with 100 % specificity. In tuberculosis, the sensitivity were up to 93.3%. Conclusion: Cytology and closed pleural biopsy are good choices to diagnose pleural effusions. Cytology has low yield in malignancy whereas CPB is very effective in Tuberculosis pleural effusions and can be the first choice. We recommend CPB in malignant pleural effusions when the patient had chronic diseases that may prevent general anesthesiaand when Pleuroscoby is not available as in low economic countries.[Full Text Article]