Comparative study between medical thoracoscopic and ultrasound-guided transthoracic pleural biopsies in diagnosis of tuberculous pleural effusion

<bold>Background:</bold> Tuberculosis (TB) is a multisystemic disease caused by Mycobacterium tuberculosis. Extrapulmonary TB can occur as part of a primary or late, generalized infection. Tuberculous pleurisy is the second most common extrapulmonary tuberculosis. The aim of this study is to assess and compare the diagnostic efficacy of medical thoracoscopic and ultrasound-guided transthoracic pleural biopsies in the diagnosis of tuberculous pleural effusion (TPE). <bold>Methods:</bold> This is a prospective randomized clinical study of 30 patients suspected of having TPE based on clinical, radiological, and laboratory data and referred for diagnosis. All the patients were randomized into two groups. Group A underwent medical thoracoscopy, while Group B underwent ultrasound-guided transthoracic needle biopsies. Biopsy specimens were subjected to histopathological and microbiological analysis. Patients in group B with inconclusive results underwent subsequent medical thoracoscopy. <bold>Results:</bold> After exclusion of non-tuberculous pleural effusion cases, 13 cases underwent medical thoracoscopy, of which 12 cases (92.3%) were confirmed as TPE. 14 cases underwent ultrasound-guided transthoracic needle biopsy, of which 12 cases (85.7%) confirmed TPE. This did not reveal a statistically significant difference in results between medical thoracoscopy and ultrasound-guided transthoracic needle biopsy; the p value for comparing between them was 1.000. <bold>Conclusion:</bold> Based on our findings, we suggest an ultrasound-guided biopsy for patients suspected of having TPE, as it is a less invasive, rapid bedside intervention with fewer complications.