Head and Neck Lymphadenopathy: Evaluation with US-guided Cutting-Needle Biopsy

Screaton, Nicholas; Berman, Laurence; Grant, J. W.

doi:10.1148/radiol.2241010602

Cited by 128 publications

(156 citation statements)

References 39 publications

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“…It is important to note that the lack of precise subtyping/grading in a minority of cases did not preclude a therapeutic decision to be made for 62/63 patients (98%) with lymphoma. These rates not only compare favourably with those obtained in more homogeneous patient populations (de Kerviler et al, 2000(de Kerviler et al, , 2007Demharter et al, 2001;Screaton et al, 2002;Balestreri et al, 2005;Li et al, 2005;Sklair-Levy et al, 2005;de Larrinoa et al, 2007;Lachar et al, 2007) but also with results usually obtained by complete lymph node analysis. On the other hand, the diagnostic yield of CNB for diagnosis of benignity was only 53%, confirming that a definitive diagnosis for a benign disorder is a difficult task.…”

Section: Discussionsupporting

confidence: 85%

“…By slightly modifying the orientation of the cannula, multiple samples can be obtained in different representative portions of the lesion, providing valuable information (while partial) on nodal architecture in most cases. Thus, image-guided Diagnostic precision of multisampling CNB P Loubeyre et al large-cutting CNB has been proposed as the initial procedure for the diagnosis of deep-seated lymphomas (de Kerviler et al, 2000;Demharter et al, 2001;Balestreri et al, 2005;Li et al, 2005;SklairLevy et al, 2005;Lachar et al, 2007;de Larrinoa et al, 2007), and in some institutions for suspect peripheral lymph nodes (Screaton et al, 2002;de Kerviler et al, 2007). Although variable endpoints were analysed in those studies with highly diverse designs, CNB appears to be a valuable approach with sensitivity for diagnosing lymphoma at 87 -89% (Demharter et al, 2001;Balestreri et al, 2005), overall diagnostic yield at 84% , unequivocal diagnosis of lymphoma at 91% (Lachar et al, 2007), overall diagnostic accuracy for lymphoma typing at 88% (de Larrinoa et al, 2007), sufficient information such that a therapeutic decision could be made at 96% (de Kerviler et al, 2007) and diagnosis of lymphoma with subtyping ranging from 76 to 85% (de Kerviler et al, 2000;Li et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…However, the validity of CNB for lymphoma diagnosis is still controversial, and entire lymph node removal is often proposed as the best procedure Engert and Dreyling, 2008;Tilly and Dreyling, 2008). Moreover, most of the studies (de Kerviler et al, 2000;Demharter et al, 2001;Screaton et al, 2002;Balestreri et al, 2005;Li et al, 2005;Sklair-Levy et al, 2005;de Kerviler et al, 2007;de Larrinoa et al, 2007;Lachar et al, 2007) include patients with a high probability of lymphoma diagnosis assessed in reference centres for lymphoproliferative diseases. This study was designed to determine whether CNB can also be recommended in the context of a primary care hospital where a large range of malignant and benign diagnoses can be expected.…”

Section: Discussionmentioning

confidence: 99%

“…However, the excisional biopsy of enlarged lymph nodes is still advocated as the gold standard in the diagnostic evaluation of lymphoma Engert and Dreyling, 2008;Tilly and Dreyling, 2008). Nonetheless, in several centres, percutaneous image-guided CNB, which is a minimally invasive procedure, is used as an alternative to excisional biopsy for diagnosing lymphomas (de Kerviler et al, 2000;Demharter et al, 2001;Screaton et al, 2002;Balestreri et al, 2005;Li et al, 2005;Sklair-Levy et al, 2005;Lachar et al, 2007;de Kerviler et al, 2007;de Larrinoa et al, 2007). This is particularly true if suspected nodes or masses are deep seated or if the clinical condition of patients is severely impaired.…”

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confidence: 99%

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Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital

Loubeyre¹,

Mckee²,

Copercini³

et al. 2009

Br J Cancer

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We evaluated the diagnostic quality of image-guided multisampling core needle biopsy (CNB) in patients investigated for suspected lymphoma in a primary care hospital. A total of 112 patients were consecutively assessed during a 3-year period. There were 80 lymphoid site biopsies and 32 non-lymphoid site biopsies. Eight to nine cores were obtained from different parts of the biopsy site. Two cores were systematically frozen, allowing for further morphological, immunochemistry and molecular studies. The diagnostic yield of CNB for malignancy was 100%. Only 47% (41/87) of patients with initial suspicion of lymphoma were finally diagnosed with Lymphoma. The diagnostic yield of CNB for lymphoma typing was 98% (62/63), according to the WHO classification. The diagnostic yield of CNB for complete lymphoma subtyping/grading was 86% (54/63). The diagnostic yield of CNB for a definite diagnosis of benignity was only 47% (8/17). In a primary care setting, multisampling CNB is a minimally invasive, and very accurate procedure for confirming malignancy in patients with suspected lymphoma, presenting with superficial/deep-seated, lymphoid/non-lymphoid site targets. With a very high diagnostic yield for lymphoma typing and a high diagnostic yield for complete lymphoma subtyping/grading a therapeutic decision can be taken in most patients.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital

Loubeyre¹,

Mckee²,

Copercini³

et al. 2009

Br J Cancer

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“…Also, ultrasound is used for biopsy selection in the case of unexplained lymphadenopathy (Screaton et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Real Time Elastography in Patients with Unexplained Cervical Lymphadenopathy: Quantitative Evaluation

Fu¹,

Yun-fei²,

Yan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Ultrasonography is non-invasive and can give useful clues in the diagnosis of cervical lymphadenopathy, However, differential diagnosis is difficult in some situations even combined with color Doppler imaging. The present study was conducted to evaluate the clinical value of real time elastography in patients with unexplained cervical lymphadenopathy using a quantitative method. From May 2011 to February 2012, 39 enlarged lymph nodes from 39 patients with unexplained cervical lymphadenopathy were assessed. All the patients were examined by both B-mode ultrasound, color Doppler flow imaging and elastography. The method of analyzing elasto-graphic data was the calculation of the 10 parametres ("mean", "sd", "area%", "com", "kur", "ske", "con", "ent", "idm", "asm") offered by the software integrated into the Hitachi system. The findings were then correlated with the definitive tissue diagnosis obtained by lymph node dissection or biopsy. Final histology revealed 10 cases of metastatic lymph nodes, 11 cases of lymphoma, 12 cases of tuberculosis and 6 cases of nonspecific lymphadenitis. The significant distinguishing features for conventional ultrasound were the maximum short diameter (p=0.007) and absent of echogenic hilum (p=0.0293). The diagnostic accuracy was 43.6% (17/39 cases) and there were 17 patients with equivocal diagnosis. For elastography, "mean" (p=0.003), "area%" (p=0.009), "kurt" (p=0.0291), "skew" (p=0.014) and "cont" (p=0.012) demonstrated significant differences between groups. With 9 of the 17 patients with previous equivocal diagnoses (52.9%) definite and correct diagnoses could be obtained. The diagnostic accuracy for conventional ultrasound combined elastography was 69.2% (27/39 cases). There were differences in the diagnostic sensitivity of the two methods (p=0.0224). Ultrasound combined with elastography demonstrated higher rates of conclusive and accurate diagnoses in patients with unexplained cervical lymphadenopathy than conventional ultrasound. The quantitative program showed good correlation with the pathology of different lymph node diseases.

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Automatic Core Needle Biopsy

Nyquist¹,

Tom²,

Mui³

2008

Arch Otolaryngol Head Neck Surg

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Head and Neck Lymphadenopathy: Evaluation with US-guided Cutting-Needle Biopsy

Abstract: US-guided core biopsy in patients with head and neck lymphadenopathy is a safe outpatient procedure that has a high diagnostic yield and accuracy and frequently obviates surgery.

Cited by 128 publications

References 39 publications

Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital

Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital

Clinical Value of Real Time Elastography in Patients with Unexplained Cervical Lymphadenopathy: Quantitative Evaluation

Automatic Core Needle Biopsy

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