Sir,I read the recent publication on percutaneous closed-needle pleural biopsy and undiagnosed exudative pleural effusion with great interest. Hira et al. have concluded that “The role of percutaneous closed needle biopsy of pleura among patients of undiagnosed exudative pleural effusion is still accepted as a diagnostic tool, as this may lead to a specific diagnosis among 76% of cases.[1]” Hira et al. tried to use the economical limitation to support this conclusion. The question is whether the test with high false results and not favorable specificity could be acceptable. I agree to the problem of resource limitation; however, it is needed to be proved for the cost-effectiveness if the conclusion is tried to be set up based on the medical economic reason. Finally, it is noted that using a percutaneous closed-needle biopsy helps diagnosis result in increased complication rates of pneumothorax, pneumomediastinum, and subcutaneous emphysema.[2]