Role of thoracoscopic pleural biopsy in low Adenosin DeAminase pleural effusions: A hospital based cross sectional study

Background: To obtain the good amount of specimen by biopsy for proper diagnosis, thoracoscopy is a very good tool. Using thoracoscopy the diagnostic accuracy can reach 100% whereas the diagnostic accuracy of the closed pleural biopsy is around 51-79%. Aim: To study role of thoracoscopic pleural biopsy in low Adenosin DeAminase pleural effusions. Material and Methods: A hospital based cross sectional study was carried out among 50 study subjects aged > 45 years. All were cases of pleural effusion. Thoracoscopic pleural biopsy was performed in all cases. The samples were sent for histopathology after biopsy. Results: Majority of the study subjects were found to be in the age group of 45-55 years i.e. 60%. Males outnumbered females as the pleural effusion may be more common in males above the age of 45 years than among the females. Tuberculosis was more in females (60%) than males (40%). But malignancy – adenocarcinoma spreading to pleura was more common in males (90.5%) than females (9.5%). Only one female was found to have Meigs syndrom (ovarian tumor with secondaries pleura). Mesothelioma was seen in three cases and all of them were males. Normal histopathology finding was seen in five cases and all of them were males. It has been documented that pleural effusion due to tuberculosis was more common in females in the present study. Conclusion: Thoracoscopic pleural biopsy diagnostic yield is high. Low ADA level in pleural fluid does not rule out kochs, incidence more in females.