Characteristics of pericardial biopsy: 100 cases in a single center

Ortal Fallek Boldes, Shani Dahan, Yahel Segal, Dana Ben Ami Shor, Robert K. Huber, Iris Barshack, Yuval Horowitz, Gad Segal, Amir Dagan

    Research output: Contribution to journalArticlepeer-review

    1 Scopus citations

    Abstract

    Background: Pericardial biopsies are rarely performed during the diagnosis and management of pericardial diseases. The circumstances and clinical profile of patients undergoing pericardial biopsies are largely uncharacterized. Objectives: To examine the circumstances in which pericardial biopsies are obtained and to evaluate their diagnostic yield. Methods: We studied a total of 100 cases (71% males, mean age 60.8 years, range 8.1–84.5 years) of surgically resected pericardium specimens obtained from 2000 to 2015 at Sheba Medical Center, the largest medical center in Israel. Patients were classified into groups according to four major histological etiologies: idiopathic pericarditis, constrictive pericarditis, malignant pericarditis, and post-cardiac injury syndrome (PCIS). The clinical history and course, laboratory, echocardiography, and histological results were reviewed retrospectively. Results: Causes of pericarditis according to histological definitions included idiopathic pericarditis (29%), constrictive pericarditis (29%), PCIS (9%), and malignant pericarditis (26%). Overall sensitivity of the pericardial biopsy in patients with malignancy was 57.7%. During the study period, we found a trend toward an increased number of biopsies due to constrictive pericarditis and PCIS, along with a decrease in the number of biopsies performed in patients with malignant or idiopathic pericarditis. The diagnosis following biopsy did not change for any of the patients. Conclusions: Our findings suggest a low diagnostic yield from pericardial biopsies, especially in malignant pericarditis. This conclusion, along with novel therapies, resulted in the infrequent use of pericardial biopsy in recent years.

    Original languageEnglish
    Pages (from-to)183-187
    Number of pages5
    JournalIsrael Medical Association Journal
    Volume21
    Issue number3
    StatePublished - 1 Mar 2019

    Keywords

    • Autoimmunity
    • Biopsy
    • Malignancy
    • Pericarditis
    • Pericardium

    ASJC Scopus subject areas

    • Medicine (all)

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