Randomized Comparison of Power Doppler Ultrasound-Directed Excisional Biopsy With Standard Excisional Biopsy for the Characterization of Lymphadenopathies in Patients With Suspected Lymphoma

Picardi, Marco; Gennarelli, Nicola; Ciancia, Rosanna; Renzo, Amalia De; Gargiulo, Giovanna; Ciancia, Giuseppe; Sparano, Lucianna; Zeppa, Pio; Martinelli, Vincenzo; Pettinato, Guido; Lobello, R; Pane, Fabrizio; Rotoli, Bruno

doi:10.1200/jco.2004.02.171

Cited by 29 publications

(53 citation statements)

References 18 publications

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“…It is also not always an innocuous procedure; complications are well known and depend on the site of dissection. They include temporary/permanent seromas, lymphoceles, flap margin necrosis, wound infections, limb edemas, or thrombophlebitis [13,14]. In addition, patients may exhibit at least permanent unesthetic cervical scars and residual pain, whereas the treatment of the underlying disease is non-surgical.…”

Section: Discussionmentioning

confidence: 98%

Image-guided core-needle biopsy of peripheral lymph nodes allows the diagnosis of lymphomas

et al. 2006

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It is commonly admitted that the diagnosis of lymphomas can be assessed by the image-guided needle biopsy (IGNB) of deep lymph nodes. However, when peripheral lymph nodes are present, surgical dissection remains the standard strategy. The aim of this study was to evaluate the diagnostic yield of IGNB of peripheral lymph nodes in patients with suspected lymphomas. The records of 180 multisampling IGNBs of peripheral lymph nodes in 180 patients were reviewed. One hundred and twenty-three IGNBs were observed at first diagnosis and 57 at progression using large-cutting core-biopsy needles ranging between 18 G and 14 G in size. Immunohistochemistry studies were performed in all cases and at least one biopsy was systematically frozen. A diagnosis of lymphoma with sufficient information such that a therapeutic decision could be made was obtained in 146 of the 152 patients with lymphoproliferative disorders (96%). IGNB was equally effective in making the correct diagnosis of lymphoma at the time of original diagnosis than at relapse. The results did not depend on the biopsy site, lymph nodes size, or needle type. We recommend that IGNB may be performed as an initial procedure for the diagnosis of lymphomas either in the presence of peripheral or deep lymph nodes, as it avoids surgery.

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Section: Discussionmentioning

confidence: 98%

Image-guided core-needle biopsy of peripheral lymph nodes allows the diagnosis of lymphomas

et al. 2006

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“…C-1). 26 Because one of the goals of the study was to evaluate the possible benefit of US high resolution and Power Doppler US-assistance, cases in which FNC had been performed under CT control were not considered in the present study. In all the cases of the second group, the first smear was immediately Diff-Quik stained and evaluated (ICE) while the patient was still in the outpatient office; ICE identified four inadequate cases (scantily or non cellular and/or, blood contaminated) which were repeated and classified accordingly.…”

Section: Methodsmentioning

confidence: 99%

Fine‐needle aspiration cytology in the follow‐up of Hodgkin lymphoma

Zeppa¹,

Picardi²,

Cozzolino³

et al. 2008

Diagnostic Cytopathology

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Hodgkin lymphoma (HL) is characterized by long survival and risk of relapse and second neoplasm. The aim of this study is to evaluate the possibility of improving the accuracy of fine-needle cytology (FNC) in HL follow-up using Power Doppler ultrasound (US) assistance and immediate microscopic evaluation (ICE). The study was performed in two consecutive groups of 200 FNC in HL patients. In the first group FNC of palpable lymph-nodes or extra lymph-nodal masses were performed without US assistance except for impalpable and/or deep located masses (nonassisted group); In the second group, all the FNC were performed under Power Doppler US assistance with ICE and immediately repeated in inadequate cases (assisted group). Cytological diagnoses were controlled by histology (61) or clinical follow-up (69); sensitivity and specificity were calculated in the two groups and to evaluate the effect of Power Doppler alone, adequate cases were compared with the total number of FNC in each of the two groups.FNC identified 90 negative cases, 3 false negatives, 70 HL relapse, 16 inadequate and 14 suspicious; second neoplasia were diagnosed in 12 cases and all histologically confirmed. Sensitivity and specificity were 64 and 84% in the nonassisted group and 86 and 94% in the assisted group and there were significant differences between the number of adequate cases v.s. the total number of FNC in each of the two groups. Sensitivity and specificity in assisted FNC are higher than in nonassisted ones. The main advantage of assisted FNC in the follow-up of HL is to produce accurate diagnoses avoiding invasive biopsies.

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“…Aus der sonographischen Untersuchung lassen sich bei Nachweis von Verkalkungen wesentliche Verdachtsmomente für eine Lymphknotentuberkulose ableiten [18]. Die diagnostische Zuverlässigkeit einer Lymphknotenbiopsie bei Malignomverdacht lässt sich durch sonographisch assistierte Biopsie optimieren [26].…”

Section: Bildgebende Diagnostikunclassified

Differenzialdiagnose und -abklärung von Lymphknotenvergrößerungen

Jung

Trümper

2008

Internist

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Besides acute inflammatory swelling of a lymph node, acute lymphadenitis, enlarged lymph nodes occur in conjunction with various benign and malignant diseases. Lymphadenopathy can appear in a localized or generalized form and requires further diagnostic measures. Possible causes are primarily infectious, immunological, neoplastic, and metabolic disorders. The medical history and physical examination provide the first clues to the diagnosis. Localized swollen glands often have an infectious etiology so that the first step is to identify the possible focus of infection. Generalized lymphadenopathy is frequently a sign of a hematological systemic disease, particularly in adults. Therefore, in every case of lymphadenopathy persisting for more than 1 month, invasive diagnostic procedures are indicated to rule out a malignant cause. The aim should be to perform a histological analysis; excision of entire lymph nodes is exigent, especially for the work-up of lymphoma. In cases of malignant lymphoma, staging examinations should subsequently be conducted to assess the prognosis and formulate a treatment plan.

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Randomized Comparison of Power Doppler Ultrasound-Directed Excisional Biopsy With Standard Excisional Biopsy for the Characterization of Lymphadenopathies in Patients With Suspected Lymphoma

Abstract: Power Doppler US is an accurate tool for screening lymphadenopathies to be removed by excisional biopsy in patients with suspected lymphoma.

Cited by 29 publications

References 18 publications

Image-guided core-needle biopsy of peripheral lymph nodes allows the diagnosis of lymphomas

Image-guided core-needle biopsy of peripheral lymph nodes allows the diagnosis of lymphomas

Fine‐needle aspiration cytology in the follow‐up of Hodgkin lymphoma

Differenzialdiagnose und -abklärung von Lymphknotenvergrößerungen

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