[Pleural effusion: diagnostic usefulness of pleural puncture biopsy]

To assess the diagnostic usefulness of thoracocentesis with pleural needle biopsies, we retrospectively studied 316 procedures performed in 254 patients between 1977 and 1984. Of these, 130 were ultimately found to have pleural malignant disease, with a diagnostic cytologic study in 60% of the patients, a positive pleural biopsy in 52.30% and both methods combined in 81.53% of the patients. The marginal gains from pleural biopsy in the presence of negative cytology results were 63.46%. In 59 patients, the primary neoplasm was lung cancer, the most frequent tumor (45.30%); in second place, 30 patients presented carcinoma of the breast (23%). Needle biopsy of the pleura proved to be nonspecific for the diagnosis of nonmalignant diseases except for tuberculous pleurisy: in our study 55 patients presented tuberculosis (21.65%) and in 35 of them, the pleural biopsy was characteristic. The culture of pleural fluid revealed Koch bacillus in 5.45% of these patients. Routine culture of biopsy specimen for tubercle bacillus was not carried out. Complications occurred in 4.4% of needle biopsies, with no death.