Image-Guided Cutting-Edge-Needle Biopsy of Peripheral Lymph Nodes and Superficial Masses for the Diagnosis of Lymphoma

Abstract

Percutaneous image-guided needle biopsy is a safe and reliable procedure with a high diagnostic yield. It can be used as a first step in patients suspected of having lymphoma presenting with enlarged peripheral lymph nodes and superficial masses.

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

“…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.…”

“…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.…”

“…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.…”

Can cutting-needle biopsy be an alternative to excisional biopsy in lymph node pathologies?

“…CnB allows the enlarging lymph nodes to be distinguished not just as benign or malignant, but can even lead to diagnoses of the HL and nHL subtypes (12). Subtyping of some lymphomas can be very difficult with CnB but subtyping in excisional biopsies may also be impossible (8). In the literature, different ratios for the sensitivity and specificity of image-guided biopsy and 2 (18.2%) as MCL.…”

“…Instead of excision of deeply-located lymph nodes, especially in the difficult to reach mediastinum or abdomen, the CnB procedure reduces the patient's morbidity and hospital stay and provides considerable advantages (15,16). recent developments in histopathological and especially immunohistochemical examination have changed the CnB approach and made it possible to make a diagnosis even in small tissue specimens (8,11,15). CnB allows the enlarging lymph nodes to be distinguished not just as benign or malignant, but can even lead to diagnoses of the HL and nHL subtypes (12).…”