TY - JOUR
T1 - Formulating a Treatment Plan in Suspected Lymphoma
T2 - Ultrasound-Guided Core Needle Biopsy Versus Core Needle Biopsy and Fine-Needle Aspiration of Peripheral Lymph Nodes
AU - Drylewicz, Monica R.
AU - Watkins, Marcus P.
AU - Shetty, Anup S.
AU - Lin, Michael F.
AU - Salter, Amber
AU - Bartlett, Nancy L.
AU - Middleton, William D.
AU - Yano, Motoyo
N1 - Publisher Copyright:
© 2018 by the American Institute of Ultrasound in Medicine
PY - 2019/3
Y1 - 2019/3
N2 - Objectives: Image-guided tissue sampling in the workup of suspected lymphoma can be performed by core needle biopsy (CNB) or CNB with fine-needle aspiration (FNA). We compared the yield of clinically actionable diagnoses between these methods of tissue sampling. Methods: All ultrasound-guided percutaneous peripheral lymph node biopsies from 2010 to 2017 at a single institution were retrospectively reviewed for biopsy type (CNB versus CNB + FNA), prior diagnosis of lymphoma, size of the target lymph node, number of cores, length of core specimens, and pathologic diagnosis. Lymphoma and lymphoid tissue were included; metastatic disease and nonlymphoid tissue were excluded. An oncologist specializing in lymphoma independently determined whether an actionable diagnosis could be made with the pathologic results in the context of the patient's medical record. χ2 analyses and univariable/multivariable logistic regression models were used for statistical analyses. Results: Of 578 lymph node biopsies, 306 (53%) had a prior diagnosis of lymphoma; 273 (47%) were CNB, and 305 (53%) were CNB + FNA. There was no significant difference between biopsy types (CNB versus CNB + FNA) in the number of cores (median [25th, 75th percentiles], 3 [3, 4] versus 4 [3, 4]; P =.47) or total length of tissue (4.1 [2.5, 6.1] versus 3.7 [2.3, 6] cm; P =.09). There was no difference in obtaining an actionable diagnosis between biopsy types after controlling for a known history of lymphoma (P =.271) or after controlling for the number of core specimens (P =.826). Conclusions: In cases of suspected lymphoma, CNB without FNA was sufficient to obtain an actionable diagnosis.
AB - Objectives: Image-guided tissue sampling in the workup of suspected lymphoma can be performed by core needle biopsy (CNB) or CNB with fine-needle aspiration (FNA). We compared the yield of clinically actionable diagnoses between these methods of tissue sampling. Methods: All ultrasound-guided percutaneous peripheral lymph node biopsies from 2010 to 2017 at a single institution were retrospectively reviewed for biopsy type (CNB versus CNB + FNA), prior diagnosis of lymphoma, size of the target lymph node, number of cores, length of core specimens, and pathologic diagnosis. Lymphoma and lymphoid tissue were included; metastatic disease and nonlymphoid tissue were excluded. An oncologist specializing in lymphoma independently determined whether an actionable diagnosis could be made with the pathologic results in the context of the patient's medical record. χ2 analyses and univariable/multivariable logistic regression models were used for statistical analyses. Results: Of 578 lymph node biopsies, 306 (53%) had a prior diagnosis of lymphoma; 273 (47%) were CNB, and 305 (53%) were CNB + FNA. There was no significant difference between biopsy types (CNB versus CNB + FNA) in the number of cores (median [25th, 75th percentiles], 3 [3, 4] versus 4 [3, 4]; P =.47) or total length of tissue (4.1 [2.5, 6.1] versus 3.7 [2.3, 6] cm; P =.09). There was no difference in obtaining an actionable diagnosis between biopsy types after controlling for a known history of lymphoma (P =.271) or after controlling for the number of core specimens (P =.826). Conclusions: In cases of suspected lymphoma, CNB without FNA was sufficient to obtain an actionable diagnosis.
KW - biopsy
KW - core
KW - fine-needle aspiration
KW - lymphoma
KW - ultrasound guided
UR - http://www.scopus.com/inward/record.url?scp=85061515733&partnerID=8YFLogxK
U2 - 10.1002/jum.14724
DO - 10.1002/jum.14724
M3 - Article
C2 - 30043431
AN - SCOPUS:85061515733
SN - 0278-4297
VL - 38
SP - 581
EP - 586
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
IS - 3
ER -