Percutaneous Image-Guided Biopsy of the Spleen: Experience at a Single Tertiary Care Center

John, Susan; Shabana, Wael; Salameh, Jean‐Paul; McInnes, Matthew D. F.

doi:10.1177/0846537120903692

Cited by 12 publications

(4 citation statements)

References 22 publications

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“…Therefore, a surgical procedure would be unnecessary and will not treat systemic disease. Because of the high blood flow to the spleen, biopsy used to be rather uncommon due to the inherent high risk of bleeding, with studies reporting a high rate of complications [6,7]. But as an operation with splenectomy is also not without its risks, it can be an advantage to perform a percutaneous biopsy and spare patients a splenectomy [8].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Computed Tomography (CT) Fluoroscopy-Guided Biopsy of the Spleen Using Fibrin Glue as a Sealant

Segger,

Lerchbaumer,

Collettini

et al. 2024

Diagnostics

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Some authors consider the risk of bleeding an absolute contraindication to percutaneous image-guided splenic puncture. While splenic punctures are mainly performed at specialized centers, no technique for the closure of the puncture tract has been broadly established. The aim of this study was to investigate the effectiveness and safety of a percutaneous image-guided biopsy of the spleen using fibrin glue to plug the tract. A total of 27 requests for splenic image-guided interventions were identified between 2010 and 2021 and considered for inclusion in our retrospective single-center study. Seven patients needed to be excluded, which left twenty patients who underwent a percutaneous computed tomography (CT) fluoroscopy-guided biopsy of a splenic lesion during this period. In all patients, a 17G coaxial needle with an 18G core biopsy needle was used. Diagnostic adequacy and accuracy were evaluated, and complications were classified using the CIRSE classification system for adverse events. Diagnostic adequacy was 100% (20/20), and a median of four samples were collected. Diagnostic accuracy was 80% (16/20). The four off-target samples included one inconclusive finding and three samples of regular spleen tissue. The overall complication rate was 5% (1/20). No mild (grade 1–2) or moderate (grade 3–4) complications occurred. One severe (grade 5–6) complication occurred. Although controversial and potentially high-risk, diagnostic percutaneous biopsies of the spleen appear to be relatively safe with the use of fibrin glue to seal the tract.

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Section: Introductionmentioning

confidence: 99%

Percutaneous Computed Tomography (CT) Fluoroscopy-Guided Biopsy of the Spleen Using Fibrin Glue as a Sealant

Segger,

Lerchbaumer,

Collettini

et al. 2024

Diagnostics

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“…There are many diseases of the spleen, including nonneoplastic, benign neoplastic, and malignant lesions. [1] Splenic lesions of non-Hodgkin and Hodgkin lymphomas are found in 30% to 40% of patients with lymphoma. [2] Splenic metastases of solid tumors are clinically rare, although studies in autopsy cases have reported splenic metastases in 1.6% to 30% of cases.…”

Section: Introductionmentioning

confidence: 99%

“…[2] Imaging using ultrasound (US), computed tomography (CT), and magnetic resonance can help in understanding lesion characteristics. [1] However, although advances in imaging have improved the sensitivity of lesion detection, specificity does not appear to have improved. For example, the accuracy Medicine of imaging for lymphomatous lesions in the spleen is 58% to 65%.…”

Section: Introductionmentioning

confidence: 99%

Exploration of predictors associated with bleeding in computed tomography-guided core needle splenic biopsy: A retrospective study

Masuda,

Tsukiyama,

Daigo

et al. 2023

Medicine

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Splenic diseases may be caused by infections and can be either malignant, such as lymphoma and lung cancer, or benign, such as hemangioma. In some cases, diagnostic uncertainty of imaging persists, and image-guided splenic needle biopsy is a useful diagnostic tool to avoid the disadvantages of incorrect diagnosis, including performing unnecessary splenectomy or not giving the necessary treatment. Splenic biopsies can be divided into ultrasound-guided, computed tomography (CT)-guided fine-needle aspiration, or core needle biopsy (CNB). However, few studies have focused exclusively on complications associated with CT-guided CNB of the spleen. Therefore, we assessed bleeding, the most common complication of CT-guided CNB of the spleen, and evaluated factors associated with the bleeding. Using the biopsy database maintained at the institution, all patients who underwent CT-guided CNB of the spleen between May 2012 and September 2022 were identified retrospectively. The 18 identified patients were divided into post-biopsy bleeding and non-bleeding groups for analysis. In total, 17 patients (94.4%) could be diagnosed accurately with CT-guided CNB. Bleeding complications occurred in 7 cases of CT-guided CNB; of these, 2 patients with Common Terminology Criteria for Adverse Events grade 4 disease required transcatheter arterial embolization. The bleeding group was characterized by diffuse spleen tumors in all cases, with significantly more diffuse spleen tumors than the non-bleeding group. CT-guided CNB is a useful option for neoplastic lesions of the spleen that are difficult to diagnose using imaging alone. However, consideration should be given to post-biopsy bleeding in patients with diffuse splenic tumors.

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“…Nowadays, diagnostic splenectomy is reserved for cases where other methods fail to identify a specific entity [ 5 , 6 ]. Splenic biopsies, although feasible, carry the risk of hemorrhage and may not always be representative [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

How to Diagnose and Treat CD5-Positive Lymphomas Involving the Spleen

et al. 2021

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Patients with CD5-expressing lymphomas presenting with splenomegaly are frequently diagnosed with chronic lymphocytic leukemia. The most important differential diagnosis is mantle cell lymphoma, both in its classical and leukemic, non-nodal forms, given its prognostic and therapeutic implications. Other small B-cell neoplasms that frequently involve the spleen and occasionally express CD5 include the splenic marginal zone lymphoma, hairy cell leukemia and, rarely, lymphoplasmacytic lymphoma. The frequency of CD5 positivity depends in part on the sensitivity of the detection methods employed. Usually, a combination of morphological, immunophenotypic and molecular findings allows for a precise sub-classification of CD5-positive, low-grade B-cell lymphomas of the spleen. Some of these tumors may display a mixture of small and larger B cells, raising the possibility of more aggressive lymphomas, such as diffuse large B-cell lymphomas (DLBCL). Approximately 5–10% of DLBCL are CD5-positive and some may manifest as primary splenic lesions. When available, the morphology of DLBCL in the splenic tissue is distinctive and a leukemic picture is very rare. In conclusion, the appropriate morphological and clinical context assisted by flow cytometry panels and/or immunohistochemistry allows the differential diagnosis of CD5-positive, non-Hodgkin, B-cell lymphomas involving the spleen.

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Percutaneous Image-Guided Biopsy of the Spleen: Experience at a Single Tertiary Care Center

Cited by 12 publications

References 22 publications

Percutaneous Computed Tomography (CT) Fluoroscopy-Guided Biopsy of the Spleen Using Fibrin Glue as a Sealant

Percutaneous Computed Tomography (CT) Fluoroscopy-Guided Biopsy of the Spleen Using Fibrin Glue as a Sealant

Exploration of predictors associated with bleeding in computed tomography-guided core needle splenic biopsy: A retrospective study

How to Diagnose and Treat CD5-Positive Lymphomas Involving the Spleen

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