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Updated: Aug 19, 2026

Use of Electromagnetic Navigational Transthoracic Needle Aspiration (E-TTNA) for Sampling of Lung Nodules
Published on: May 23, 2015
The case for performing pleural biopsies for the aetiological diagnosis of exudates. Yes
1Unidad Médico-Quirúrgica de Enfermedades Respiratorias (UMQER), Hospital Universitario Virgen del Rocío, Sevilla, España; Laboratorio de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, España.
Abstract:
Pleural biopsies are especially indicated in the following circumstances: a) inconclusive pleural fluid analysis and negative sputum study, if adenosine deaminase (ADA) levels are unavailable; b) suspected multi-resistant tuberculosis; c) a need for differentiating tuberculous pleurisy (if it progresses with neutrophilia) and complicated parapneumonic effusion; d) malignant pleural effusion coexisting with very high ADA levels; e) effusion coexisting with lung cancer and negative pleural cytology; f) suspected mesothelioma; and g) need for implementing re-treatment for patients with relapse after chemotherapy. Image-guided needle biopsy is recommended for cases a and b, while thoracoscopy is preferable for the other cases.
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