الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY
We reported the results of 50 consecutive pleural
biopsies with Ramel pleural biopsy needle 3-5 times
through the same setting to indicate the
effictiveness, safety and ease of the procedure
Adequate pleural tissue was obtained in all the 50
cases including those taken in the absence of pleural
fluid (2 cases) A diagnostic thoracentesis was done
for 48 cases .
The diagnosis was pleural tuberculosis in 8
cases malignant neoplasia in 29 cases 9
adenocarcinoma. 3 squamous cell carcinoma. 4
mesothelioma. 3 metastatic adenocarcinoma and 10
anaplastic carcinoma In 13 cases ; the aspect was
normal (5 cases), nonspecific inflammation (b cases).
and fibrosed calcified pleura (2 cases)
In three of the eight patients with tUberCulos~S.
mycobacterium tuberculosis grew from culture of pleural
flUid . One patient with a nondiagnostic pleural biopsy
also had a pleural fluid culture that grew
mycobacterium tuberculosis Pleural biopsy was the
sole means of diagnosis in 7 patients .
Twenty of the 29 patients with malignancy had
diagnostic pleural biopsy. and pleural biopsy alone
identified 7 patients with malignant neoplasm and
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negative pleural fluid cytology Pleural fluid
cytology diagnosed 4 patients with non diagnostic
biopsies . Combined cytologic and histologic results of
the pleural effusions and needle biopsies established
the diagnosis of malignancy in 24 cases with a
percentage of 83% Open biopsy was required to
establish the diagnosis in 5 cases of malignant
neoplasm
The initial pleural biopsy
diagnostic of malignant neoplasm in
tuberculous disease in 7 patients .
procedure was
20 patients and
A nonspecific or
normal result was found in 23 patients (46%). Malignant
neoplasm or tuberculosis was eventually established in
10 and excluded in 2 of the 23 patients. In the
remaining 11 patients. no diagnosis was made
The procedure’s sensitivities were 69% (malignant
neoplasm) and 88% (tuberculosis) No false positive
results occured The specificity and positive
predictive value were 100%. The negative predictive
value was 47% .
Postoperatively. the patients felt well. and there
were no complications
The technique of pleural biopsy with Ramel needle
is easier to perform and provides adequate tissue for
biopsy .
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Ramel needle is safe and is a valuable diagnostic
procedure in the diagnosis of pleural effusions of
nonobvious cause especially if combined with pleural
fluid analysis .
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