Abstract:To evaluate the safety and diagnostic yield of CT-guided core-needle biopsy (CNB) versus fine-needle aspiration biopsy (FNAB) of lung nodules and masses in patients with hematologic malignancies (HMs).
Materials and Methods:With institutional review board approval, 166 patients were retrospectively reviewed between 2007 and 2017 who were diagnosed with leukemia, lymphoma, or myelodysplastic syndromes (with or without hematopoietic stem cell transplant) and who underwent CT-guided FNAB and/or CNB of the lung. P… Show more
“…Although both fine-needle aspiration biopsies and core-needle biopsies can be used to diagnose mould infections, a consensus was achieved for transthoracic core-needle biopsies owing to their higher diagnostic yield ( figure 1 ). 58 , 59 , 60 , 61 The complication rates of transthoracic core-needle biopsies and fine-needle aspirates have been similar in the studies published before the COVID-19 pandemic. 58 , 59 , 60 , 61 , 62 However, considering the possibility of severe bleeding in patients with suspected CAPM, an alternative approach of performing a fine-needle aspiration cytology with on-site cytopathological examination might be considered before proceeding with core-needle biopsies.…”
Section: Resultsmentioning
confidence: 66%
“… 58 , 59 , 60 , 61 The complication rates of transthoracic core-needle biopsies and fine-needle aspirates have been similar in the studies published before the COVID-19 pandemic. 58 , 59 , 60 , 61 , 62 However, considering the possibility of severe bleeding in patients with suspected CAPM, an alternative approach of performing a fine-needle aspiration cytology with on-site cytopathological examination might be considered before proceeding with core-needle biopsies. Figure 1 Diagnostic algorithm for evaluating suspected CAPM CAPM=COVID-19-associated pulmonary mucormycosis.…”
“…Although both fine-needle aspiration biopsies and core-needle biopsies can be used to diagnose mould infections, a consensus was achieved for transthoracic core-needle biopsies owing to their higher diagnostic yield ( figure 1 ). 58 , 59 , 60 , 61 The complication rates of transthoracic core-needle biopsies and fine-needle aspirates have been similar in the studies published before the COVID-19 pandemic. 58 , 59 , 60 , 61 , 62 However, considering the possibility of severe bleeding in patients with suspected CAPM, an alternative approach of performing a fine-needle aspiration cytology with on-site cytopathological examination might be considered before proceeding with core-needle biopsies.…”
Section: Resultsmentioning
confidence: 66%
“… 58 , 59 , 60 , 61 The complication rates of transthoracic core-needle biopsies and fine-needle aspirates have been similar in the studies published before the COVID-19 pandemic. 58 , 59 , 60 , 61 , 62 However, considering the possibility of severe bleeding in patients with suspected CAPM, an alternative approach of performing a fine-needle aspiration cytology with on-site cytopathological examination might be considered before proceeding with core-needle biopsies. Figure 1 Diagnostic algorithm for evaluating suspected CAPM CAPM=COVID-19-associated pulmonary mucormycosis.…”
“…8,14 Our data did not show a correlation between CNB and an increased risk for bleeding which is comparable to similar studies in other organ sites, including liver and kidney. 23,24 ROSE plays an essential role in splenic FNA and CNB specimen triage for additional testing, leading to improved diagnostic rates. lymphoid aggregates containing cells in various stages of maturation with many isolated lymphoid cells in background.…”
Introduction: Splenic fine needle aspiration (FNA) and core needle biopsies (CNB) are rare specimen types, potentially avoided due to clinical concern for hemorrhagic complications. The safety and utility of splenic FNA, the role of rapid onsite evaluation (ROSE), as well as the diagnostic utility of CNB versus FNA have not been recently reviewed.Materials and methods: A 10-year retrospective review was performed of percutaneous image-guided FNA and CNB of the spleen. Clinical indications, outcomes, ROSE findings, and final diagnoses were reviewed and correlated.Results: Forty-four specimens from 39 patients were identified. The commonest indication for biopsy was a radiographic mass found during assessment for patient complaint (45%, 20/44), evaluation for malignancy (primary or metastatic) (39%, 17/44), and incidentally (16%, 7/44). Malignant diagnoses were rendered in 10 cases, 80% hematolymphoid and 20% nonhematolymphoid. Thirty-one cases were nonneoplastic and identified as infectious/inflammatory processes 39%, cysts 10%, vascular lesions 13%, benign splenic elements 22%, accessory or atrophic spleen 10%, and extramedullary hematopoiesis 6%. The nondiagnostic rate was 7%. Cases with subsequent splenectomy showed 100% specificity and 86% sensitivity. The concordance of ROSE and final interpretation was 90% within the neoplastic category. Finally, the significant complication rate was 6.8% with no bias to occurrence following FNA or CNB.Conclusions: This series affirms the safety and efficacy of splenic FNA and CNB by complication rates comparable to prior studies and high rate of concordance. The diagnostic accuracy may be further improved by ROSE, and CNB in cases reliant on staining and tissue architecture.
“…A retrospective review of 166 patients with hematologic malignancy found bleeding complications more likely in those with a history of hematopoietic stem cell transplant. 18…”
Section: Relative Contraindicationsmentioning
confidence: 99%
“…Patients with hematologic malignancies are also considered high risk because of decreased or defective platelets, anemia, and immunosuppression. A retrospective review of 166 patients with hematologic malignancy found bleeding complications more likely in those with a history of hematopoietic stem cell transplant 18 …”
Percutaneous computed tomography-guided transthoracic lung biopsy is an effective and minimally invasive procedure to achieve tissue diagnosis. Radiologists are key in appropriate referral for further workup, with percutaneous computed tomography-guided transthoracic lung biopsy performed by both thoracic and general interventionalists. Percutaneous computed tomography-guided transthoracic lung biopsy is increasingly performed for both diagnostic and research purposes, including molecular analysis. Multiple patient, lesion, and technique-related variables influence diagnostic accuracy and complication rates. A comprehensive understanding of these factors aids in procedure planning and may serve to maximize diagnostic yield while minimizing complications, even in the most challenging scenarios.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
