Ultrasound‐guided fine needle biopsy of the spleen: High clinical efficacy and low risk in a multicenter Italian study

Abstract

The aim of this study was to evaluate the clinical efficacy and safety of the ultrasoundguided fine needle biopsy (UG-FNB) of the spleen in a large population of patients. We collected retrospectively the findings concerning the application of UG-FNB of the spleen from eight Italian clinical centers that utilized this technique for at least ten years. A data schedule was sent to all centers to collect information about techniques, results, and complications of UG-FNB of the spleen. We analyzed 398 biopsy procedures both on focal lesions (257 cases) and on splenic parenchyma (141 cases). The overall accuracy was 90.9% for the series as a whole, 84.9% for cytological sampling, 88.3% for microhistological sampling, and 90.3% for both cytological and histological sampling (double biopsy). Tissue core biopsy yielded better overall accuracy in patients with suspected splenic involvement by lymphoma (90.9% vs. 68.5% for cytology). The complication rate was low (no death cases, less than 1% for major complications, and 5.2% for all complications). No predictive factors were able to detect high-risk situations. The operator's skill (higher number of performed procedures) was significantly related to better overall accuracy. Conversely, the complication rate was not affected. UG-FNB of the spleen is a very effective diagnostic procedure with low risk for the patient. Aspiration cytology and core needle biopsy showed similar diagnostic yields, except for the diagnosis of splenic lymphoma, in which core needle biopsy obtained better results. Am. J. Hematol. 67:93-99, 2001.

Percutaneous Image-guided Biopsy of the Spleen: Systematic Review and Meta-Analysis of the Complication Rate and Diagnostic Accuracy

“…Because imaging has not been demonstrated to be accurate for diagnosis, tissue samples from the spleen may be required to stage or diagnose malignancy or to assess for possible infection ( 1,2 ). Tissue samples can be obtained either by using splenectomy or percutaneous biopsy ( 2,(5)(6)(7). Splenectomy carries a relatively high reported morbidity (8.6%-37%) and mortality (0%-2.9%) rate, primarily because of infection (7)(8)(9).…”

Classificação citológica dos linfomas caninos

“…No homem e no cão cada vez mais há estudos que empregam a PAAF para o diagnóstico deste tipo de neoplasia 4,22,23,24,25 . Nos casos de linfadenomegalia, este exame permite a diferenciação rápida entre processos reacionais benignos e neoplásicos 26 . Quando há suspeita de lesão ou alteração em órgãos internos, como vísceras abdominais ou torácicas, a PAAF também pode ser realizada com auxílio da ultrassonografia 26 .…”

“…Nos casos de linfadenomegalia, este exame permite a diferenciação rápida entre processos reacionais benignos e neoplásicos 26 . Quando há suspeita de lesão ou alteração em órgãos internos, como vísceras abdominais ou torácicas, a PAAF também pode ser realizada com auxílio da ultrassonografia 26 . Segundo a literatura, existe uma excelente correlação entre os resultados obtidos pela PAAF e por biopsias, tanto na classificação morfológica como na imunofenotipagem dos linfomas 25,27 .…”

Fever of unknown origin revealed to be primary splenic lymphoma: A rare case report with review of the literature

“…Both sFNA and sCB are safe for patients with splenomegaly, and certain studies reported they exhibit excellent diagnostic accuracy in splenic malignancies, but a relatively low efficiency in splenic lymphoma (34,35). However, other studies indicated they have a rather low diagnostic yield on account of inadequate specimenin addition, in a review of 49 cases there was an overall complication rate of 16%, and complications such as bleeding and splenic rupture may have a fatal outcome (36,37).…”