الفهرس 
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Abstract
This study was conducted in Al-Abbasia chest hospital and Giza chest hospital. In the current study the average age of studied patients (mean +SD) was 29.23 year (9.48)+SD.
The study conducted on 71 patients with undiagnosed exudative pleural effusion and suspected to be tuberculous (as regarding our inclusive criteria).
In this study, most cases were males (74.65%), 11.27% of cases are not Egyptians but are Africans, all cases has no history of TB, almost all cases have toxic manifestations (loss of weight, loss of apetite, night fever, night sweating).
More than half of patients gave positive reaction to Tuberculin sensitivity test.
In this study, the sputum of all cases was negative for AFB. All cases were with normal routine investigations.
The majority of pleural fluid was rich in lymphocytes; ADA (mean+SD) was 24.01+9.9.
Gene X-pert of pleural fluid of studied cases was negative in77.46% of cases.
Medical Thoracoscope was done to studied patients, in 59.15% of studied patients the medical Thoracoscopic picture showed thickened parietal pleura with simple adhesions and diffuses micronodules while 32.39% of them presented with thick pleura and 8.45% had extensive capsular fibrin deposition. The histology was compatible with TB in all patients with pleural biopsy.
The gold standard for a diagnosis of pleural TB is the isolation of M. tuberculosis from biological samples; in its absence, a diagnosis can be achieved by histology of pleural tissue.
In this study the 88.73% of studied patient diagnosed by histopathology, but the sensitivity of geneXpert is 22.2%,and the specificity is 75%, its positive predictive value (ppv) is 87.50% and its negative predictive value (NPV) is 10.90% and finally accuracy of test in evaluating TB pleurisy is so weak (28.6%).