Author/Editor		Rozman, Aleš; Debeljak, Andrej
Title		Slepa igelna biopsija parietalne plevre v diagnostiki plevralnega izliva
Translated title		Needle pleural biopsy in the diagnosis of pleural effusion
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 8, št. 19
Publication year		2003
Volume		str. 23-7
Language		slo
Abstract		Blind needle pleural biopsy (NBP) is used in the diagnosis of pleural effusion and pleural diseases. The effectiveness of NPB and its complications were evaluated by analysing retrospectiviley 83 NPBs done in 2001. Diagnostic specificity and sensitivity of the procedure were determined, as well as its positive and negative predictive value. Granulomatous pleuritis was found in 10.3% of patients. Tuberculous pleuritis was diagnosed in all but one of the patients with pleural involvement due to sarcoidosis. Malignant infiltration of the pleura was discovered in 39.7% of the patients studied; 15.4% had mesothelioma, and 24.3% secondary tumours infiltration of the pleura. Unspecific pleural inflammation was established in 48.7% of patients; 1.3% of cases remained undiagnosed. Pneumothorax occured in four patients, but it resolved spontaneously. The diagnostic specificity of NPB for tuberculosis and malignant pleural effusion is 100%, and its is sensitivity, 71.4% and 58.1%, respectively. The negative predictive value for tuberculosis and malignant pleural effusion is 97.3% and 78.3%, respectively, whereas the positive predictive value for both entities is 100%. NPB is a safe procedure for the diagnosis of pleural effusion and pleural diseases, associated with a low rate of unsevere complications. It usually precedes thorascopy.
Summary		S slepo igelno biopsijo parietalne plevre (SIBPP) si pomagamo do diagnoze v prirnerih plevralnega izliva in bolezni plevre. Z retrospektivno analizo 83 opravljenih SIBPP v letu 2001 smo ovrednotili uspešnost izvedbe posega in njegove zaplete. Opredelili smo specifičnost in občutljivost preiskave ter njeno pozitivno in negativno napovedno vrednost. Granulomski plevritis smo ugotovili pri 10,3% preiskovancev. Razen enega primera prizadetosti plevre zaradi sarkoidoze so imeli vsi bolniki tuberkulozo. 39,7% bolnikov je imelo maligno infiltracijo hlevre; pri 15%; je šlo za mezoteliom. pri ostalih 24,3% pa je bila plevra sekundarno tumorsko infiltrirana. Nespecitični plevritis smo našli pri 48,7% bolnikov, medtem ko v 1,3% nismo prišli do diagnoze. Od zapletov beležimo 4 pnevmotorakse, ki so se spontano rcsorbirali. Specifičnost SIBPP v diagnostiki tuberkuloznega in malignega plevralnega izliva je 100%, občutljivost pa 71,4% za bolnike s tuberkuloznim izlivom in 58,1% za bolnike z malignim plevralnim izlivom. Pozitivna napovedna vrednost preiskave je 100% za tuberkulozo in malignom, negativna napovedna vrednost pa je 97,3% za tuberkulozo in 78,3% za malignom. SIBPP je varna preiskavna rnetoda za diagostiko plevralnega izliva in bolezni plevre z maloštevilnimi in za bolnika nenevarnimi zapleti. lma mesto pred torakoskopijo.
Descriptors		PLEURAL EFFUSION BIOPSY, NEEDLE PREDICTIVE VALUE OF TESTS SENSITIVITY AND SPECIFICITY TUBERCULOSIS, PULMONARY PLEURAL EFFUSION, MALIGNANT