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Pleural Biopsy

Louis J. Kettel, MD; David W. Cugell, MD
JAMA. 1967;200(4):317-320. doi:10.1001/jama.1967.03120170089018.
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A disease process in the periphery of the lung commonly involves the parietal pleura and frequently is associated with an effusion. Careful study of the chemical, bacteriologic, and cellular composition of pleural fluid may be highly informative and occasionally diagnostic, but the results of these studies also may be nonspecific despite definite diagnostic histological changes in the pleura. The value of microscopic examination of a portion of pleura was established initially from specimens obtained by open surgical biopsy through a limited thoracotomy.1 This initiated interest in needle biopsy which has now largely replaced the more complex open surgical procedure. Tuberculosis, other granulomatous diseases, and tumors, either primary or metastatic to the pleura, are the most common specific diagnoses obtained from pleural biopsy specimens.

The biopsy needle removes a small fragment of parietal pleura suitable for histological examination. Three general types of needles have been used: (1) Vim-Silvermann, an end-biting


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