Comparison of ultrasound‐guided core‐needle biopsy and fine‐needle aspiration in the assessment of head and neck lesions

Abstract

Sonography and if necessary FNA should continue to be the investigation method of first choice for head and neck lesions. The main indication for CNB is after repeated failures of FNA to provide a diagnosis. It can also be performed in patients who are not surgical candidates or in those who refuse surgery.

Validity of core needle biopsy in the histopathological verification of parotid gland lesions

“…In the study by Kraft et al (24), needle-track seeding was found in only one sample of 75 patients. In the mentioned study, core-needle biopsy was performed with 20 gayge-sized needle, and neck dissection was performed on the same day, so it cannot be said with certainty that the cells would survive longer in the tissue after seeding.…”

Core-needly biopsy of parotid gland masses

“…Po mišljenju Krafta evaluacija nove metode kao što je core-needle biopsija trebalo bi da bude bazirana na poređenju histo-patoloških nalaza dobijenih novom metodom sa histo-patološkim nalazima dobijenim nakon hirurške ekstirpacije tumefakta u vratu, što je zlatni standard u ovoj oblasti. Core-needle biopsija u odnosu na fine-needle aspiration metodu obezbeđuje bolju diferencijaciju limfoidne hiperplazije od limfoma, kao i bolje određivanje subtipova i gradiranje karcinoma 27 . sa druge strane, komplikacije same core-needle biopsije (krvarenje, infekcija, povreda nerva) nisu veće ni češće u odnosu na komplikacije FNa 28 .…”

“…Howlett i saradnici su 2007. takođe pokazali senzitivnost, specifičnost i tačnost od 100% u histopatološkoj verifikaciji neoplazmi i detektovanju maligniteta u studiji sa 135 pacijenata kojima je rađena core biopsija tumefakta u parotidnoj regiji 36 . U sličnoj studiji, screaton 2002. godine opisuje senzitivnost od 98%, specifičnost od 100% i tačnost od 99% u diferenciranju benignih od malignih limfadenopatija, ali je samo 23% od 260 pacijenata podvrgnuto otvorenoj ekstirpaciji limfnog čvora ili disekciji vrata, dok je u ostalim slučajevima definitivna dijagnostika bila potvrđena kliničkim i laboratorijskim nalazom 37 …”

Fine-Needle Aspiration Followed by Core-Needle Biopsy in the Same Setting: Modifying Our Approach

“…Table 4 summarizes the advantages of the combined procedure. Therefore, and as shown by other investigators, the utilization of both aspirate smears and core tissue biopsy material are complementary and have added value compared to either one alone [7,13,26,29,33,35,38,39,44,45,46,47,50,51,52,57,58,59,60,61,62,68,75,76,77,78]. …”

“…In their study on head and neck lesions, Kraft et al [51] found that CNB was superior to FNAB in a few aspects - providing a specific diagnosis, identifying true neoplasms and detecting malignancy. In this study, the investigators compared the results obtained by CNB that was performed immediately before the surgical excision of the lesion and compared these with a prior FNAB diagnosis in 68 patients with head and neck masses.…”