Polymerase chain reaction of pleural biopsy specimens for rapid diagnosis of tuberculous pleuritis

SETTING: Government-administered regional teaching hospital. OBJECTIVE: To improve timeliness and sensitivity of laboratory diagnosis of tuberculous pleuritis. DESIGN: We applied polymerase chain reaction (PCR) to detect DNA (IS6110) specific for Mycobacterium tuberculosis complex in pleural biopsy specimens. RESULTS: Of 28 patients with pleural disease, 11 were diagnosed by microbiology (smear/culture of sputum or pleural fluid) with tuberculous pleuritis, eight were diagnosed with tuberculous pleuritis by histology (of pleural biopsies) and/or clinical presentation, and nine were diagnosed with carcinomatous pleuritis. Seventeen of the patients' pleural biopsies were PCR positive. Based on microbiological results, the sensitivity of the PCR assay was 100% (11/11). On the other hand, based on the results of the histological and clinical data, sensitivity and specificity of the PCR results were 89% (17/19) and 100% (9/9), respectively. CONCLUSION: PCR of pleural biopsy specimens can be a useful method when employed in combination with microbiological and histological examinations of pleural biopsy for rapid diagnosis of tuberculous pleuritis.