Ultrasound‐guided core needle biopsies for workup of lymphadenopathy and lymphoma

Groneck, Laura; Quaas, Alexander; Hallek, Michael; Zander, Thomas; Weihrauch, Martin R.

doi:10.1111/ejh.12742

Cited by 36 publications

(63 citation statements)

References 34 publications

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“…It usually requires hospitalization, a surgical procedure with at least local anesthetic and sedation, and has a greater risk of complications. CNB has been increasingly used to obtain material for histopathology but is a sampling technique with its own limitations and complication rate [22]. For the most frequent causes of LAP, such as benign reactive hyperplasia, specific infections or a metastasis from a known or unknown primary tumor, LN-FNAC is an accurate, quick, and cost-effective procedure, often making LN excisional biopsy an unnecessary and costly alternative.…”

Section: Ln-fnac Indicationsmentioning

confidence: 99%

A Proposal for the Performance, Classification, and Reporting of Lymph Node Fine-Needle Aspiration Cytopathology: The Sydney System

et al. 2020

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Background: The evaluation of lymph nodes (LN) by fine-needle aspiration cytology (FNAC) is routinely used in many institutions but it is not uniformly accepted mainly because of the lack of guidelines and a cytopathological diagnostic classification. A committee of cytopathologists has developed a system of performance, classification, and reporting for LN-FNAC. Methods: The committee members prepared a document that has circulated among them five times; the final text has been approved by all the participants. It is based on a review of the international literature and on the expertise of the members. The system integrates clinical and imaging data with cytopathological features and ancillary techniques. The project has received the endorsement and patronage of the International Academy of Cytology and the European Federation of the Cytology Societies. Results: Clinical, imaging, and serological data of lymphadenopathies, indications for LN-FNAC, technical procedures, and ancillary techniques are evaluated with specific recommendations. The reporting system includes two diagnostic levels. The first should provide basic diagnostic information and includes five categories: inadequate/insufficient, benign, atypical lymphoid cells of undetermined/uncertain significance, suspicious, and malignant. For each category, specific recommendations are provided. The second diagnostic level, when achievable, should produce the identification of specific benign or malignant entities and additional information by utilizing ancillary testing. Conclusion: The authors believe that the introduction of this system for performing and reporting LN-FNAC may improve the quality of the procedure, the report, and the communication between cytopathologists and the clinicians. This system may lead to a greater acceptance and utilization of LN-FNAC and to a better interdisciplinary understanding of the results of this procedure.

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Section: Ln-fnac Indicationsmentioning

confidence: 99%

A Proposal for the Performance, Classification, and Reporting of Lymph Node Fine-Needle Aspiration Cytopathology: The Sydney System

et al. 2020

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“…Fourth, there were few false-positive and false-negative results on PET/CT. Lastly, there was no case of surgical excisional biopsy, which may affect the results even though US-guided tissue sampling is a well-known first-line investigation of choice that is safe, cost effective, and fast with a high diagnostic efficacy in cervical LNs [28][29][30]. We expect that further studies with larger sample sizes and various targeted patients will validate our results in the near future.…”

Section: Discussionmentioning

confidence: 62%

Cervical Lymph Nodes Detected by F-18 FDG PET/CT in Oncology Patients: Added Value of Subsequent Ultrasonography for Determining Nodal Metastasis

et al. 2019

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Background and Objectives: To investigate the diagnostic performance of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and subsequent ultrasonography (US) for determining cervical nodal metastasis in oncology patients. Materials and Methods: Fifty-nine cervical lymph nodes (LNs) initially detected by PET/CT with subsequent neck US were included in this retrospective study. All LNs were subjected to US-guided fine-needle aspiration or core needle biopsy. The maximum standardized uptake value (SUVmax) and sonographic features were assessed. Results: Forty-three of 59 cervical LNs detected by PET/CT were malignant. PET/CT alone showed a highest diagnostic value for metastatic LNs with 81.4% sensitivity, 68.8% specificity, and 78% accuracy when SUVmax ≥5.8 was applied as an optimal cut-off value. Combined PET/CT and subsequent US diagnoses for determining nodal metastasis showed the following diagnostic performance: 81.4% sensitivity, 87.5% specificity, and 83.1% accuracy. There was a significant difference in the diagnostic performance between the two diagnostic imaging approaches (p = 0.006). Conclusions: Combined diagnosis using subsequent US showed a significantly higher diagnostic performance for determining nodal metastasis in the neck. Therefore, we believe that our proposed diagnostic strategy using subsequent US can be helpful in evaluating cervical LNs on PET/CT. Moreover, our results clarify the need for US-guided tissue sampling in oncology patients.

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“…[ 6 ] Surgical biopsy of the lymph node is accepted as the gold standard for accurate diagnosis of these neoplasms. [ 7 8 ] But this invasive procedure for biopsy not only increases the patient's pain but also is costly, time consuming, and has complications. [ 6 ] Therefore, in recent years, minimally invasive techniques have been used to diagnose lymphoma.…”

Section: Introductionmentioning

confidence: 99%

“…Among minimally invasive techniques, core needle biopsy (CNB) has been widely accepted as an effective tool for the diagnosis of malignant lymphoma, carcinoma, and deep tumors that are only accessible by CT or endoscopic-guided. [ 8 9 ] For patients with manifestations of peripheral lymphadenopathy also fine-needle aspiration cytology (FNA) is using as a diagnostic tool, but the diagnostic capabilities of this technique are limited and provide only cytomorphological information. [ 8 10 ] In addition, although sono-fine needle aspiration cytology (US-FNA) is useful in the diagnosis of lymphadenopathy, FNA, especially in patients with lymphoma, has a high false-negative rate and is unable to accurately classify lymphoma.…”

Section: Introductionmentioning

confidence: 99%

“…[ 8 9 ] For patients with manifestations of peripheral lymphadenopathy also fine-needle aspiration cytology (FNA) is using as a diagnostic tool, but the diagnostic capabilities of this technique are limited and provide only cytomorphological information. [ 8 10 ] In addition, although sono-fine needle aspiration cytology (US-FNA) is useful in the diagnosis of lymphadenopathy, FNA, especially in patients with lymphoma, has a high false-negative rate and is unable to accurately classify lymphoma. [ 11 ] Therefore, CNB is increasingly used as a subcutaneous sampling technique and is a cheap, fast, simple and well tolerated method.…”

Section: Introductionmentioning

confidence: 99%

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Investigation of the value of ultrasound-guided core needle biopsy from pathologic lymph nodes to the diagnosis of lymphoma

Elhamdoust

Motamedfar

Gharibvand

et al. 2020

J Family Med Prim Care

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Introduction: In recent years, techniques with minimally invasive have been gradually developed and used in the diagnosis of lymphoma. Among minimally invasive techniques, core needle biopsy (CNB) has been widely accepted as an effective tool for the diagnosis of malignant lymphoma, carcinoma and deep tumors that are only accessible via CT or endoscopic-guided. This study was conducted to investigate of diagnostic value of ultrasound guided CNB in the diagnosis of lymphoma in all parts of the body compared to surgical excisional biopsy (SEB). Materials and Methods: This is an descriptive epidemiological study that was performed on patients with suspected lymphoma referred to the intervention ward of Golestan Hospital in Ahvaz in 2019. For all patients with suspected lymphoma, CNB of lymph nodes was performed by ultrasound-guided. Finally, the final diagnosis of CNB was compared with the results of surgical biopsy in the studied specimens. Results: In this study, 40 patients were evaluated with suspected lymphoma. At initial diagnosis with CNB, 12 (30%) had NHL, 19 (47.5%) had Hodgkin's lymphoma, and 2 had high-grade lymphoma. Of the 40 patients examined, 29 required IHC to confirm the diagnosis. In 8 cases, the final diagnosis was done using SEB. Final diagnosis in 9 (22.5%) patients was confirmed by CNB only. The CNB along with the IHC also led to the final diagnosis in 23 (57.5%) patients. However, another 8 patients required biopsy to confirm the diagnosis by SEB. Conclusion: The findings of this study indicated that US-CNB is a highly efficient method of diagnosis of lymphoma with high specificity, in the fastest possible mode and with the least complications.

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Ultrasound‐guided core needle biopsies for workup of lymphadenopathy and lymphoma

Abstract: Ultrasound-guided CNBs are a safe, quick, and valid tool for the workup of lymphadenopathy. Yet, a benign diagnosis from CNB must be completed by a secondary biopsy if clinical presentation suggests malignant disease.

Cited by 36 publications

References 34 publications

A Proposal for the Performance, Classification, and Reporting of Lymph Node Fine-Needle Aspiration Cytopathology: The Sydney System

A Proposal for the Performance, Classification, and Reporting of Lymph Node Fine-Needle Aspiration Cytopathology: The Sydney System

Cervical Lymph Nodes Detected by F-18 FDG PET/CT in Oncology Patients: Added Value of Subsequent Ultrasonography for Determining Nodal Metastasis

Investigation of the value of ultrasound-guided core needle biopsy from pathologic lymph nodes to the diagnosis of lymphoma

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