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Fu Y, Liu C, Ren M, Du T, Wang Y, Mei F, Cui L. Accuracy of ultrasound-guided fine-needle aspiration for small cervical lymph nodes: A retrospective review of 505 cases. Heliyon 2024; 10:e31238. [PMID: 38803905 PMCID: PMC11128987 DOI: 10.1016/j.heliyon.2024.e31238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose The overall diagnostic value of fine-needle aspiration (FNA) is not as excellent as that of core needle biopsy (CNB). Limited research has investigated small cervical lymph nodes inaccessible to ultrasound-guided CNB due to technical challenges associated with their small size. Therefore, this study aimed to evaluate the accuracy of ultrasound-guided FNA in determining the etiology of small cervical lymph nodes. Methods A retrospective analysis was conducted on patients who underwent FNA between May 2018 and May 2021 at our hospital. Cytological, histopathological, and clinical follow-up data were analyzed. The diagnostic yield of FNA was assessed based on sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy calculations. Results This study included 505 patients, each with a small cervical lymph node under evaluation (total number of lymph nodes: 505). The average maximal diameter of the lymph nodes was 14.6 ± 6.2 mm. According to the Sydney system, the cytology results were as follows: Category I in 26 lymph nodes (5.1 %); Category II in 269 (53.3 %); Category III in 35 (6.9 %); Category IV in 17 (3.4 %); and Category V in 158 (31.3 %). We identified 212 malignant cases (203 metastases and 9 lymphomas) and 293 benign lymph nodes. FNA achieved high sensitivity (88.8 %), specificity (99.6 %), PPV (99.4 %), NPV (91.8 %), and overall accuracy (94.8 %) in determining the etiology of small cervical lymph nodes. Conclusion FNA cytology is suitable for small lesions inaccessible by CNB and provides a diagnostic basis for implementing clinically appropriate treatment measures.
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Affiliation(s)
- Ying Fu
- Department of Ultrasound, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Chang Liu
- Department of Ultrasound, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Minglei Ren
- Department of Ultrasound, The 901th Hospital of the Joint Logistics Support Force of PLA, Hefei, 230031, China
| | - Tingting Du
- Department of Ultrasound, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yihua Wang
- Department of Ultrasound, North China University of Science and Technology Affiliated Hospital, 73 South Jianshe Road, Lubei District, Tangshan, 066300, China
| | - Fang Mei
- Department of Pathology, Peking University Third Hospital, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
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Yao DW, Qin MZ, Jiang HX, Qin SY. Comparison of EUS-FNA and EUS-FNB for diagnosis of solid pancreatic mass lesions: a meta-analysis of prospective studies. Scand J Gastroenterol 2024:1-8. [PMID: 38769625 DOI: 10.1080/00365521.2024.2354908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
Objective: To quantitatively compare the diagnostic value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) in solid pancreatic mass lesions using a systematic evaluation method.Methods: A systematic literature search was conducted on public databases to include studies comparing the diagnostic value of EUS-FNA and EUS-FNB in solid pancreatic mass lesions. The combined effect size was estimated using mean difference (MD) and risk difference (RD) respectively, and the corresponding 95% confidence interval (CI) was calculated.Results: The 12 articles (7 RCTs and 5 cohort studies) met the inclusion criteria of this study. The meta-analysis showed that compared with EUS-FNB, EUS-FNA had lower diagnostic accuracy (RD: -0.08, 95% CI: -0.15, -0.01) and specimen adequacy (RD: -0.08, 95% CI: -0.15, -0.02), while higher required number of needle passes (MD: 0.42, 95% CI: 0.12, 0.73). However, EUS-FNB and EUS-FNA presented similar overall complications (RD: 0.00, 95% CI: -0.01, 0.02) and technical failures (RD: -0.01, 95% CI: -0.02, 0.00), without statistically significant differences.Conclusions: Compared with EUS-FNA, EUS-FNB seems to be a better choice for diagnosing suspected pancreatic lesions.
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Affiliation(s)
- Dun-Wei Yao
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Department of Gastroenterology, The Southwest Affiliated Hospital of Youjiang Medical University for Nationalities, Baise City, Guangxi Zhuang Autonomous Region, China
| | - Min-Zhen Qin
- Department of Gastroenterology, The Southwest Affiliated Hospital of Youjiang Medical University for Nationalities, Baise City, Guangxi Zhuang Autonomous Region, China
| | - Hai-Xing Jiang
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shan-Yu Qin
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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3
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Bran W, Sahli‐Vivicorsi S, Cadieu R, Alavi Z, Leclere J. Ultrasound-guided hookwire localization of non palpable cervical lymphadenopathy: A case-control study of operative time. Cancer Med 2023; 12:16054-16065. [PMID: 37317644 PMCID: PMC10469735 DOI: 10.1002/cam4.6257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE We aimed at evaluating the impact of ultrasound-guided (US) hookwire localization of nonpalpable cervical lymphadenopathy on operating time. DESIGN AND METHODS Retrospective case control study (January 2017 and May 2021) of 26 patients with lateral nonpalpable cervical lymphadenopathy undergoing surgery with (H+) and without (H-) per operative US-guided hook-wire localization. Operative time (general anesthesiology onset, hookwire placement, end of surgery) and surgery-related adverse events data were collected. RESULTS Mean operative time was significantly shorter in H+ group versus H- group (26 ± 16 min vs. 43 ± 22 min) (p = 0.02). Histopathological diagnosis accuracy was 100% versus 94% (H+ vs. H-, p = 0.1). No significant between group difference in surgery-related adverse events was reported (wound healing, p = 0.162; hematomas, p = 0.498; neoplasms removal failure, p = 1). CONCLUSION US-guided hookwire localization of lateral nonpalpable cervical lymphadenopathy allowed a significant reduction in operative time, comparable histopathological diagnosis accuracy and adverse events compared with H-.
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Affiliation(s)
- William Bran
- Radiology DepartmentBrest University HospitalBrestFrance
- ENT DepartmentBrest University HospitalBrestFrance
| | | | - Romain Cadieu
- Radiology DepartmentBrest University HospitalBrestFrance
| | - Zarrin Alavi
- INSERM, CIC 1412Brest University HospitalBrestFrance
| | - Jean‐Christophe Leclere
- Radiology DepartmentBrest University HospitalBrestFrance
- ENT DepartmentBrest University HospitalBrestFrance
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Cavallo M, Ciliberti V, Maffei E, Serio B, Sabbatino F, Zeppa P, Caputo A. An economic evaluation of fine-needle cytology as the primary diagnostic tool in the diagnosis of lymphadenopathy. Open Med (Wars) 2023; 18:20230719. [PMID: 37305522 PMCID: PMC10251160 DOI: 10.1515/med-2023-0719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 06/13/2023] Open
Abstract
Fine-needle aspiration cytology (FNAC) is commonly used to obtain a pre-surgical pathological diagnosis in many organs, but its cost-effectiveness in lymphadenopathy has not been studied yet. We calculated the cost and diagnostic accuracy of a diagnostic algorithm that uses FNAC as a first-line procedure and compared it to a purely surgical approach in 545 consecutive lymphadenopathies. In 74% of the cases, FNAC alone can obtain a sufficiently detailed diagnosis, avoiding the surgical biopsy. In doing so, the average cost of diagnosis is cut to less than one-third, the patient avoids an invasive procedure and the diagnosis is reached earlier. In conclusion, the systematic use of lymph node-FNAC in the initial assessment of lymphadenopathy is clinically and economically advantageous as it avoids surgical biopsies in cases where cytology can suffice.
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Affiliation(s)
- Monica Cavallo
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
- Department of Oncology, Haematology and Pathology, Pathology Unit, University Hospital of Salerno, Salerno, Italy
| | - Valeria Ciliberti
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
- Department of Oncology, Haematology and Pathology, Pathology Unit, University Hospital of Salerno, Salerno, Italy
| | - Elisabetta Maffei
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
- Department of Oncology, Haematology and Pathology, Pathology Unit, University Hospital of Salerno, Salerno, Italy
| | - Bianca Serio
- Department of Oncology, Haematology and Pathology, Haematology Unit, University Hospital of Salerno, Salerno, Italy
| | - Francesco Sabbatino
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
- Department of Oncology, Haematology and Pathology, Oncology Unit, University Hospital of Salerno, Salerno, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
- Pathology Unit, University Hospital of Salerno, Salerno, Italy
| | - Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
- Department of Oncology, Haematology and Pathology, Pathology Unit, University Hospital of Salerno, Salerno, Italy
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Xiao J, Meng S, Zhang M, Li Y, Yan L, Li X, Yang Z, Zhang Y, Luo Y. Optimal method for detecting cervical lymph node metastasis from papillary thyroid cancer. Endocrine 2023; 79:342-348. [PMID: 36472754 DOI: 10.1007/s12020-022-03213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/29/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Papillary thyroid cancer (PTC) is often accompanied by cervical lymph node metastases (LNM). This study compared the diagnostic performance of fine needle aspiration (FNA), the combination of FNA and thyroglobulin measurement in the washout (FNA-Tg), and core needle biopsy(CNB) in order to determine the optimal method in detecting cervical LNM from PTC. METHODS PTC patients with suspicious cervical lymph nodes, who underwent ultrasonography-guided FNA, or CNB before surgery were retrospectively reviewed between January 2021 and April 2022. Patients' demographics, lymph node size, and results of FNA, FNA-Tg, CNB and surgical pathology were collected. Sensitivitity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and the area under the curves (AUC) of receiver operating characteristic were obtained. RESULTS FNA-Tg had a higher AUC with a threshold of 55 ng/mL than that with a threshold of 1 ng/mL (0.782 vs. 0.636, P = 0.005). The sensitivity of the combination of FNA and FNA-Tg was higher than that of FNA alone (91.3% vs. 81.0%, P = 0.01), but it was not different from that of CNB (91.3% vs. 88.0%, P > 0.05). No significant difference was found in specificity, PPV, NPV, accuracy and AUC among FNA alone, CNB alone, and the combination of FNA and FNA-Tg. CONCLUSIONS FNA-Tg is useful to improve the sensitivity of FNA. The diagnostic performance of the combination of FNA and FNA-Tg is better than that of FNA or FNA-Tg alone, but is not different from that of CNB in detecting LNM from PTC.
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Affiliation(s)
- Jing Xiao
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Shuyu Meng
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Mingbo Zhang
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Yingying Li
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Lin Yan
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Xinyang Li
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Zhen Yang
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Yan Zhang
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.
| | - Yukun Luo
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.
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Salim DN, Obinah MPB, Ternov NK, McCullagh MJD, Larsen MS, Hendel HW, Hölmich LR, Chakera AH. Fine needle and core needle ultrasound guided biopsies for assessing suspected melanoma metastasis in lymph nodes and subcutaneous tissue. J Surg Oncol 2022; 126:1058-1066. [DOI: 10.1002/jso.26998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 12/20/2022]
Affiliation(s)
- David N. Salim
- Department of Plastic Surgery Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
| | - Magnus P. B. Obinah
- Department of Plastic Surgery Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
| | - Niels K. Ternov
- Department of Plastic Surgery Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
| | - Mark J. D. McCullagh
- Department of Radiology Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
| | - Mathilde S. Larsen
- Department of Pathology Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
| | - Helle W. Hendel
- Department of Clinical Physiology, Nuclear Medicine and PET Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
| | - Lisbet R. Hölmich
- Department of Plastic Surgery Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Annette H. Chakera
- Department of Plastic Surgery Copenhagen University Hospital ‐ Herlev and Gentofte Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
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Shen Y, Fang L, Ye B, Xu X, Yu G, Zhou L. The Role of Core Needle Biopsy Pathology Combined with Molecular Tests in the Diagnosis of Lymph Node Tuberculosis. Infect Drug Resist 2022; 15:335-345. [PMID: 35140479 PMCID: PMC8818765 DOI: 10.2147/idr.s350570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/14/2022] [Indexed: 12/28/2022] Open
Abstract
Background Early lymph node tuberculosis (LNTB) diagnosis is still difficult. The majority of LN specimens require the undertaking of invasive and unpleasant procedures. Purpose To evaluate the diagnostic efficacy of pathology when combined with molecular tests for the diagnosis of LNTB in core needle biopsy (CNB) specimens and to compare that diagnostic efficacy with that deriving from tissue specimens’ examination alone. Methods We retrospectively analyzed the medical records of LNTB patients who met the inclusion criteria. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of pathology, molecular tests, and parallel test (positive result for either of these two assays) were calculated to evaluate their diagnostic efficacy compared with a composite reference standard. Results A total of 289 patients were included in the study. The overall sensitivity, specificity, PPV, NPV, and AUC of pathology, molecular tests, and parallel test were 94.5%, 97.2%, 99.6%, 71.4%, 0.96; 73.1%, 100.0%, 100.0%, 34.6%, 0.87; and 98.4%, 97.2%, 99.6%, 89.7%, 0.98, respectively. For CNB specimens, these values for pathology, molecular tests, and parallel test were 93.3%, 96.2%, 99.4%, 69.4%, 0.95; 76.4%, 100.0%, 100.0%, 40.0%, 0.88; and 99.4%, 96.2%, 99.4%,96.2%,0.98, while those same values for the tissue were 96.6%, 100.0%, 100.0%, 76.9%, 0.98; 67.1%, 100.0%, 100.0%, 25.6%, 0.84; and 96.6%, 100.0%, 100.0%, 76.9%,0.98, respectively. Conclusion The validity of pathology and molecular testing when using CNB specimens was similar to that of tissue specimens for relevant assessment approaches. For the LNTB diagnosis, CNB specimens were preferred for the simultaneous undertaking of pathological examination and molecular testing.
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Affiliation(s)
- Yanqin Shen
- Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Likui Fang
- Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Bo Ye
- Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Xudong Xu
- Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Guocan Yu
- Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People’s Republic of China
- Correspondence: Guocan Yu; Lihong Zhou, Email ;
| | - Lihong Zhou
- Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People’s Republic of China
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8
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Teng D, Dong C, Sun D, Liu Z, Wang H. Comparison of Ultrasound-Guided Core Needle Biopsy Under the Assistance of Hydrodissection With Fine Needle Aspiration in the Diagnosis of High-Risk Cervical Lymph Nodes: A Randomized Controlled Trial. Front Oncol 2022; 11:799956. [PMID: 35096601 PMCID: PMC8793772 DOI: 10.3389/fonc.2021.799956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/21/2021] [Indexed: 12/07/2022] Open
Abstract
A randomized comparison of ultrasound (US)-guided core needle biopsy (CNB) under the assistance of hydrodissection with fine needle aspiration (FNA) was performed to evaluate the feasibility, safety and effectiveness for the diagnosis of high-risk cervical lymph nodes. Patients from December 2018 to May 2020 were randomly assigned to the CNB group and the FNA group at a ratio of 1:1. This study protocol was approved by the Ethics Committee of our hospital and registered in the Chinese Clinical Trial Registry (ChiCTR1800019370). The feasibility of CNB for high-risk cervical lymph nodes was evaluated by observing and recording the separation success rate (SSR) and technical success rate (TSR) of the CNB group. Safety was evaluated by comparing the incidence of major complications in the two groups. The diagnostic efficacy was evaluated by comparing the diagnostic accuracy, sensitivity, and specificity of the two groups. A total of 84 patients (84 lymph nodes) were randomized into the CNB (n = 42) and FNA (n = 42) groups. All patients in the CNB group achieved successful hydrodissection and biopsy. The SSR and TSR were both 100% in the CNB group. There were no major complications during or after the process in the two groups. Compared with the FNA group, the CNB group was significantly superior in terms of diagnostic accuracy and sensitivity (100% vs. 81.0%, P = 0.009; 100% vs. 79.2%, P = 0.035, respectively). The specificity of the two groups was 100%, and there was no significant difference. Compared with FNA, CNB under the assistance of hydrodissection is a feasible and safe method but is more effective for the diagnosis of high-risk cervical lymph nodes.
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Affiliation(s)
- Dengke Teng
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Chunhui Dong
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Daju Sun
- Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zhuo Liu
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
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Jordan R, Shlapak D, Benson J, Diehn F, Kim D, Lehman V, Liebo G, Madhavan A, Morris J, Morris P, Verdoorn J, Carr C. Percutaneous CT-Guided Core Needle Biopsies of Head and Neck Masses: Review of 184 Cases at a Single Academic Institution, Common and Special Techniques, Diagnostic Yield, and Safety. AJNR Am J Neuroradiol 2022; 43:117-124. [PMID: 34887246 PMCID: PMC8757546 DOI: 10.3174/ajnr.a7348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/14/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Percutaneous CT-guided core needle biopsies of head and neck lesions can be safely performed with vigilant planning. This largest-to-date single-center retrospective study evaluates multiple approaches with consideration of special techniques and examines the histopathologic yield. MATERIALS AND METHODS Retrospective review of CT-guided core biopsies of head and neck lesions from January 1, 2010, to October 30, 2020, was performed. We recorded the following: patient demographics, sedation details, biopsy needle type and size, lesion location and size, approach, patient positioning, preprocedural intravenous contrast, proceduralists' years of experience, complications, and pathology results. RESULTS One hundred eighty-four CT-guided core biopsies were evaluated. The initial diagnostic yield was 93% (171/184). However, of 43/184 (23%) originally "negative for malignancy" biopsies, 4 were eventually positive for malignancy via rebiopsy/excision, resulting in a 2% false-negative rate and an adjusted total diagnostic yield of 167/184 (91%). Biopsies were performed by 16 neuroradiologists with variable experience. The diagnostic yield was essentially the same: 91% (64/70) for proceduralists with ≤3 years' experience, and 90% (103/114) with >3 years' experience. The diagnostic yield was 93% (155/166) for lesions of >10 mm. The diagnostic yield per biopsy needle gauge was the following: 20 ga, 81% (13/16); 18 ga, 93% (70/75); 16 ga, 90% (64/71); and 14 ga, 91% (20/22). There were 4 asymptomatic hematomas, with none requiring intervention. CONCLUSIONS Percutaneous CT-guided core needle biopsies are safe procedures for superficial and deep head and neck lesions with a high diagnostic yield. Careful planning and special techniques may increase the number of lesions accessible percutaneously while minimizing the risk of complications.
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Affiliation(s)
- R.W. Jordan
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - D.P. Shlapak
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - J.C. Benson
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - F.E. Diehn
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - D.K. Kim
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - V.T. Lehman
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - G.B. Liebo
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - A.A. Madhavan
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - J.M. Morris
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - P.P. Morris
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - J.T. Verdoorn
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - C.M. Carr
- From the Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
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10
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Chen JV, Morgan TA, Liu C, Khanafshar E, Choi HH. Cervical Lymph Node Features Predictive of Suboptimal Adequacy During Ultrasound-Guided Fine-Needle Aspiration in Thyroid Cancer Patients. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:135-145. [PMID: 33665844 DOI: 10.1002/jum.15688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/05/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To determine the rate of cytologic and diagnostic adequacy and identify features associated with suboptimal tissue sampling in ultrasound-guided fine-needle aspiration (US-FNA) of suspected nodal disease in thyroid cancer patients. METHODS A single-institution pathology database was queried for lymph node FNA reports in thyroid cancer patients from 2014 to 2019. Charts were reviewed for demographics, body mass index (BMI), prior thyroidectomy, cancer type, and subsequent surgery. Ultrasound images were retrospectively reviewed for location, size, depth from skin, cystic components, macrocalcification, echogenic foci, and internal vascularity score. Pathology reports were categorized as cellular and diagnostic, hypocellular/acellular but diagnostic with abnormal cells or thyroglobulin levels, or hypocellular and nondiagnostic. Correlation and multivariate regression analyses were performed. RESULTS Initial query yielded 552 lesions in 343 subjects. Following exclusion, 377 lesions in 255 subjects were included. Mean patient age was 48.5 years (14-90), BMI 28.5, and 66.7% female and 33.3% male. The majority (95.3%) had papillary thyroid carcinoma (PTC); and 65.5% had prior thyroidectomy. 17.7% of lesions were hypocellular/acellular (suboptimal), and 5.6% nondiagnostic. Patient factors had no association (P >.05). Right-sidedness and hypovascularity were associated with hypocellularity (P <.05). Higher long/short-axis ratio and cystic foci were weakly associated. On multivariate analysis, right-sidedness (odds ratio [OR] 1.99; confidence interval [CI] 1.10-3.57) and lower vascularity score (OR 0.54; CI 0.39-0.73) were predictive of suboptimal sampling. CONCLUSION US-FNA has high diagnostic yield and cellular sample rate. Lesion size had no effect. Right-sidedness and lower vascularity scores were predictive of suboptimal tissue. Identifying these features and expected sample adequacy rates can inform management decisions for thyroid cancer patients with cervical lymphadenopathy.
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Affiliation(s)
- Joshua Vic Chen
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Tara A Morgan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Chienying Liu
- Department of Medicine, Division of Endocrine and Metabolism, University of California San Francisco, San Francisco, California, USA
| | - Elham Khanafshar
- Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Hailey H Choi
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
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11
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Aiken AH. Image-Guided Biopsies in the Head and Neck: Practical Value and Approach. AJNR Am J Neuroradiol 2020; 41:2123-2125. [PMID: 33060103 DOI: 10.3174/ajnr.a6855] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 11/07/2022]
Affiliation(s)
- A H Aiken
- Departments of Radiology and Imaging Sciences and Otolaryngology-Head and Neck SurgeryEmory UniversityAtlanta, Georgia
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12
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Warshavsky A, Rosen R, Perry C, Muhanna N, Ungar OJ, Carmel-Neiderman NN, Fliss DM, Horowitz G. Core needle biopsy for diagnosing lymphoma in cervical lymphadenopathy: Meta-analysis. Head Neck 2020; 42:3051-3060. [PMID: 32748464 DOI: 10.1002/hed.26381] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/06/2020] [Accepted: 06/26/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The diagnostic yield of core needle biopsies (CNB) in cervical lymphadenopathy for lymphoma diagnosis is controversial. The aim of this study was to calculate the accuracy of cervical CNB in diagnosing lymphoma. METHODS We conducted a meta-analysis of all studies on patients presenting with cervical lymphadenopathy and referred to CNB. Patients with a diagnosis other than lymphoma were excluded. All cases diagnosed with lymphoma sufficient to guide treatment based on CNB outcome were considered accurate (actionable) results. A separate meta-analysis was performed for various lymphoma subtypes. RESULTS Three prospective and 19 retrospective studies, comprising 1120 patients, met the inclusion criteria. The rate of actionable lymphoma diagnoses following CNB ranged from 30% to 96.3%, with a random-effects model of 82.45% (95% confidence interval [CI] =0.76-0.88) and a fixed-effects model of 78.3% (95% CI =0.75-0.80). CONCLUSION CNB for cervical lymphadenopathy in lymphoma cases is relatively accurate in guiding treatment.
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Affiliation(s)
- Anton Warshavsky
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Roni Rosen
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Chava Perry
- The Institute of Hematology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nidal Muhanna
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Omer J Ungar
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Narin Nard Carmel-Neiderman
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Dan M Fliss
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gilad Horowitz
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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13
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Wagner JM, Monfore N, McCullough AJ, Zhao L, Conrad RD, Krempl GA, Alleman AM. Ultrasound-Guided Fine-Needle Aspiration With Optional Core Needle Biopsy of Head and Neck Lymph Nodes and Masses: Comparison of Diagnostic Performance in Treated Squamous Cell Cancer Versus All Other Lesions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2275-2284. [PMID: 30593702 DOI: 10.1002/jum.14918] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/01/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance of ultrasound (US)-guided fine-needle aspiration with optional core needle biopsy of head and neck lymph nodes and masses, with attention to differences between biopsy of treated squamous cell carcinoma (SCC) and biopsy of other lesions. METHODS Institutional Review Board approval was obtained, and the need for consent was waived for this retrospective study. All 861 US-guided biopsies of head and neck lymph nodes and masses performed between March 1, 2012, and May 16, 2016, were reviewed. RESULTS Of the 861 biopsies, 53 targeted SCC with residual masses after treatment. The biopsy procedures yielded benign or malignant pathologic results in 71.7% (38 of 53) of treated SCC and 90.7% (733 of 808) of all other lesions (P < .001). A reference standard based on subsequent pathologic results or clinical and imaging follow-up was established in 68.4% of procedures. In cases with benign or malignant biopsy results and a subsequent reference standard, the sensitivity values for malignancy were 87.5% (95% confidence interval, 64.0%-96.5%) in treated SCC and 98.3% (95% confidence interval, 96.0%-99.3%) in all other cases (P = .047), and the specificity values were 63.6% (95% confidence interval, 35.4%-84.8%) in treated SCC and 99.5% (95% confidence interval, 97.3%-99.9%) in all other cases (P < .001). There were no major complications related to the biopsy procedures. CONCLUSIONS Excluding treated SCC, US-guided fine-needle aspiration with optional core needle biopsy of head and neck lymph nodes and masses has excellent diagnostic performance. Needle biopsy of head and neck SCC with a residual mass after therapy has a high rate of nondiagnostic samples, suboptimal sensitivity, and poor specificity.
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Affiliation(s)
- Jason M Wagner
- Departments of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Natosha Monfore
- Departments of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Austin J McCullough
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lichao Zhao
- Departments of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Dr Zhao is now affiliated with Pathology and Laboratory Medicine Services, Central Texas Veterans Health Care System, Temple, Texas, USA
| | - Rachel D Conrad
- Departments of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Greg A Krempl
- Departments of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Anthony M Alleman
- Departments of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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14
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Cheng Z, Liang P. US-guided core needle biopsy under assistance of hydrodissection to diagnose small lymph node metastases adjacent to cervical large vessels. ACTA ACUST UNITED AC 2019; 25:122-126. [PMID: 30860075 DOI: 10.5152/dir.2019.18166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE We aimed to evaluate the safety and effectiveness of ultrasonography (US) guided core needle biopsy (CNB) with hydrodissection to diagnose small lymph node metastases adjacent to cervical large vessels. METHODS From January 2013 to October 2017, 31 patients with 31 cervical lymph node metastases adjacent to large vessels presented for US-guided CNB. The mean maximal diameter of lymph nodes was 0.93±0.16 cm (range, 0.6-1.2 cm). All patients underwent US-guided CNB with 18-gauge true-cut biopsy needle after hydrodissection with saline. The separation success rate (SSR) of the hydrodissection, technical success rate (TSR) of CNB, histopathologic success rate (HST), and complications were assessed. RESULTS The SSR of hydrodissection was 100% (31/31). After effective separation between the lymph node metastases and the adjacent large vessels with saline injection, the procedures of CNB were performed with a TSR of 100% (31/31). The HST of the lymph node metastases was 100% (31/31). Two patients complained of mild cervical swelling sensation during saline injection. No major complications such as injury of the large vessels or massive hemorrhage occurred. CONCLUSION Hydrodissection can facilitate safely and effectively US-guided CNB of subcentimeter cervical lymph nodes adjacent to large vessels, potentially impacting further therapeutic decisions.
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Affiliation(s)
- Zhigang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, People's Republic of China
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15
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Fernández Aceñero MJ, Caso Viesca A, Díaz del Arco C. Role of fine needle aspiration cytology in the management of supraclavicular lymph node metastasis: Review of our experience. Diagn Cytopathol 2018; 47:181-186. [PMID: 30468321 DOI: 10.1002/dc.24064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 07/01/2018] [Accepted: 08/03/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Mª Jesús Fernández Aceñero
- Department of CytopathologyHospital Clínico Universitario San Carlos Spain
- Department of PathologyComplutense University of Madrid Madrid Spain
| | - Ana Caso Viesca
- Department of CytopathologyHospital Clínico Universitario San Carlos Spain
| | - Cristina Díaz del Arco
- Department of CytopathologyHospital Clínico Universitario San Carlos Spain
- Department of PathologyComplutense University of Madrid Madrid Spain
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16
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Ahn D, Lee GJ, Sohn JH, Jeong JY. Fine‐needle aspiration cytology versus core‐needle biopsy for the diagnosis of extracranial head and neck schwannoma. Head Neck 2018; 40:2695-2700. [DOI: 10.1002/hed.25520] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/12/2018] [Accepted: 10/09/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology‐Head and Neck Surgery, School of MedicineKyungpook National University Daegu Republic of Korea
| | - Gil Joon Lee
- Department of Otolaryngology‐Head and Neck Surgery, School of MedicineKyungpook National University Daegu Republic of Korea
| | - Jin Ho Sohn
- Department of Otolaryngology‐Head and Neck Surgery, School of MedicineKyungpook National University Daegu Republic of Korea
| | - Ji Yun Jeong
- Department of Pathology, School of MedicineKyungpook National University Daegu Republic of Korea
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17
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Dai Y, Wen Z, Ye T, Deng G, Zhang M, Deng Q, Yang Q, Shan W, Kornfeld H, Cai Y, Chen X. Empirical treatment with non-anti-tuberculosis antibiotics decreased microbiological detection in cervical tuberculous lymphadenitis. Diagn Microbiol Infect Dis 2018; 92:245-249. [PMID: 30076042 DOI: 10.1016/j.diagmicrobio.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 05/29/2018] [Accepted: 06/10/2018] [Indexed: 01/18/2023]
Abstract
Diagnosis of cervical tuberculous lymphadenitis (CTL), the most commonly occurring form of extrapulmonary tuberculosis, remains as a challenge in clinic. Detection of the presence of Mycobacterium tuberculosis (Mtb) in fine needle aspiration cytology (FNAC) samples is one golden criterion to confirm the CTL diagnosis. Due to the non-specific clinical presentation, CTL might be confused with other lymph node enlargement diseases; therefore empirical treatment with non-anti-TB antibiotics is often initially administered. However, it is still unclear whether this diagnostic antibiotic treatment affects the positivity of Mtb detection in FNAC. The demographics and clinical characteristics of 732 lymph node enlargement patients who had underwent FNAC were retrospectively analyzed and 605 (82.65%) of them were diagnosed as CTL. A total of 279 CTL cases (279/605, 46.11%) with completion of three Mtb tests (AFB, NAAT, and Mtb culture) in FNAC samples were selected for analyzing the effect of empirical antibiotic treatment on the positivity of Mtb tests. Compared to CTL patients without antibiotic treatment prior to FNAC, patients received empirical non anti-TB treatment had significantly lower positivity for acid fast bacilli staining (adjusted OR 0.11, 95% CI 0.06-0.21), nucleic acid amplification test (NAAT) (adjusted OR 0.38, 95% CI 0.21-0.71), and Mtb culture (adjusted OR 0.11, 95% CI 0.06-0.19). In conclusion, this study demonstrated that empirical non anti-TB antibiotic treatment reduced the opportunity to confirm CTL by microbiological analysis. Patients with cervical lymph node enlargement should undergo FNAC for Mtb tests prior to initiation of empirical non anti-TB treatment.
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Affiliation(s)
- Youchao Dai
- Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China; Shenzhen Key Laboratory of Infection &Immunity, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, China; Guangzhou Medical University, Guangzhou, China
| | - Zhihua Wen
- Yuebei Second People's Hospital, Shaoguan, China
| | - Taosheng Ye
- Shenzhen Key Laboratory of Infection &Immunity, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Guofang Deng
- Shenzhen Key Laboratory of Infection &Immunity, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Mingxia Zhang
- Shenzhen Key Laboratory of Infection &Immunity, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Qunyi Deng
- Shenzhen Key Laboratory of Infection &Immunity, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Qianting Yang
- Shenzhen Key Laboratory of Infection &Immunity, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Wanshui Shan
- Shenzhen Key Laboratory of Infection &Immunity, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Hardy Kornfeld
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Yi Cai
- Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China
| | - Xinchun Chen
- Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China.
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18
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Park YM, Oh KH, Cho JG, Baek SK, Kwon SY, Jung KY, Woo JS. Analysis of efficacy and safety of core-needle biopsy versus fine-needle aspiration cytology in patients with cervical lymphadenopathy and salivary gland tumour. Int J Oral Maxillofac Surg 2018; 47:1229-1235. [PMID: 29706240 DOI: 10.1016/j.ijom.2018.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 03/01/2018] [Accepted: 04/08/2018] [Indexed: 11/26/2022]
Abstract
In this study, we compared the diagnostic accuracy and safety of fine-needle aspiration cytology and core-needle biopsy in patients with cervical lymphadenopathy or salivary gland tumour, and provided a basis for selecting the appropriate diagnostic method in clinical situations. A total of 278 patients were included in this study. The sensitivities of fine-needle aspiration cytology and core-needle biopsy were 66.7% and 100%, respectively, and negative predictive values were 92.6% and 100%, respectively, for diagnosing malignancy. In diagnosing lymphoma, fine-needle aspiration cytology gave false-negative results in all patients. In diagnosing tuberculous lymphadenopathy, the sensitivities of fine-needle aspiration cytology and core-needle biopsy were 33.3% and 91.15%, respectively, and the negative predictive values were 90.0% and 95.1%, respectively. The sensitivities of fine-needle aspiration cytology and core-needle biopsy were 42.9% and 100% in diagnosing malignant salivary gland tumours, and the negative predictive values were 91% and 100%, respectively. The results of this study showed that core-needle biopsy was superior in diagnosing and distinguishing critical diseases such as malignant lymphadenopathy and tuberculosis in patients with cervical lymphadenopathy and salivary gland tumour.
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Affiliation(s)
- Y M Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K H Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - J-G Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - S-K Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - S-Y Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - K-Y Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - J-S Woo
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
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19
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Garg P, Pathak P, Goyal R, Arora VK, Singh N. Current practice in handling and reporting needle biopsies: A hospital-based survey. INDIAN J PATHOL MICR 2018; 61:197-200. [PMID: 29676356 DOI: 10.4103/ijpm.ijpm_93_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Core-needle biopsy (CNB) is a minimally invasive screening and diagnostic tool which provides intact tissue fragments for histopathological examination. Aims This study was conducted to review the current practices of handling and reporting CNBs performed for core-needle biopsies from four organ systems which are frequently encountered in our institution. These include breast, prostate, soft tissues, and lymph nodes. Settings and Design This was a retrospective study conducted at a tertiary care hospital. Materials and Methods CNB reports of breast, prostate, soft tissue, and lymph nodes were accessed and categorized based on the site of biopsy, number, and average length of the cores. The CNB reports were categorized into diagnostic or nondiagnostic. In case of diagnosis of malignancy, reports were recorded as structured or nonstructured reports. Statistical Analysis Used Fisher's exact test and Chi-square tests were applied to check the significance of the results obtained on comparing the number of cores and size of cores with the outcome of report. Results Out of 16,300 surgical pathology specimens received, 400 were CNBs comprising breast (n = 211), prostate (n = 108), soft tissue (n = 50), and lymph node (n = 31). Majority of the CNBs had 2-5 cores and the size of the core was ≥0.5 cm, which accounted for most of the reports which were diagnostic. There was a lack of clinical and radiological detail in many of the cases. Out of the malignant cases diagnosed, structured reports were given in 30% of breast, 79.3% of prostate, 41.7% soft tissue, and 60% of lymph node needle biopsies. Conclusions The audit helped to identify areas of improvement in CNB services.
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Affiliation(s)
- Paritosh Garg
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | - Priya Pathak
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | - Rachna Goyal
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | - Vinod K Arora
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | - Navjeevan Singh
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
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20
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Ahn D, Roh JH, Kim JK. Ultrasound-Guided Core Needle Biopsy for Head and Neck Mass Lesions in Patients Undergoing Antiplatelet or Anticoagulation Therapy: A Preliminary Report. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1339-1346. [PMID: 28370160 DOI: 10.7863/ultra.16.05045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/23/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES We compared the complications and diagnostic adequacy of ultrasound (US)-guided core needle biopsy (CNB) for head and neck mass lesions between patients who did and did not receive antiplatelet/anticoagulation therapy. METHODS This study was designed as a prospective case study including 146 consecutive patients who underwent US-guided CNB for head and neck mass lesions. Of these, 32 patients were undergoing antiplatelet/anticoagulation therapy involving aspirin, clopidogrel, cilostazol, and warfarin. RESULTS None of the patients had clinical bleeding/hematoma in either group. Subclinical bleeding/hematoma recognized only by a US examination was not significantly different between the groups (P = .229). No other complications were noticed. The rate of unsatisfactory sampling was also not different between the groups (P > .999). Furthermore, when patients receiving aspirin (n = 18) were reclassified into the no-antiplatelet/anticoagulation therapy group, there was still no significant difference in the incidences of complications compared with the patients receiving clopidogrel, cilostazol, or warfarin (n = 14). CONCLUSIONS Our study suggests that US-guided CNB is safe and provides good diagnostic results without necessitating the discontinuation of antiplatelet/anticoagulation therapy in patients with head and neck mass lesions. However, as this was a preliminary study, the cohort was relatively small. Larger studies are needed to confirm our findings.
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Affiliation(s)
- Dongbin Ahn
- Departments of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae-Hyung Roh
- Department of Cardiology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong Kyu Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
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21
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Ryu KH, Lee JH, Jang SW, Kim HJ, Lee JY, Chung SR, Chung MS, Kim HW, Choi YJ, Baek JH. US-guided core-needle biopsy versus US-guided fine-needle aspiration of suspicious cervical lymph nodes for staging workup of non-head and neck malignancies: A propensity score matching study. J Surg Oncol 2017. [PMID: 28650524 DOI: 10.1002/jso.24747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES To compare US-guided core-needle biopsy (USCNB) and US-guided fine-needle aspiration (USFNA) of suspicious cervical lymph nodes for staging workup of malignancies in locations other than the head and neck using propensity score matching (PSM). METHODS This retrospective cohort study included 108 patients who underwent USFNA and 1058 who underwent USCNB for suspicious cervical lymph nodes detected by imaging modalities during the staging workup for malignancies located in regions other than the head and neck. The primary outcome was defined as the inconclusive results. To evaluate the procedures according to the outcome, we performed univariate and multivariate logistic regression analyses and a 1:1 PSM of USCNB and USFNA. RESULTS There was no complication for both USFNA and USCNB. The inconclusive results were 6.5% (7/108) for USFNA and 1.6% (17/1058) for USCNB. A significantly lower rate of the inconclusive results in USCNB than in USFNA before matching was maintained after a 1:1 PSM of 103 patients from each group (before PSM, odds ratio (OR) = 4.489, 95% confidence interval (CI) [1.803-11.177], P = 0.001; after PSM, OR = 1.060, 95%CI [1.013-1.109], P = 0.012). CONCLUSIONS Because USCNB can reduce inconclusive results compared to USFNA, it could be more helpful for staging workup of malignancies in locations other than the head and neck in patients with suspicious cervical lymph nodes.
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Affiliation(s)
- Kyeong Hwa Ryu
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jeong Hyun Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Won Jang
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hwa Jung Kim
- Preventive Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ji Ye Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Department of Radiology, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sae Rom Chung
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Mi Sun Chung
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Medical Center, Seoul, Korea
| | - Hyo Weon Kim
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Jun Choi
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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22
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VanderLaan PA. Fine-needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities. Cancer Cytopathol 2016; 124:862-870. [DOI: 10.1002/cncy.21742] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 03/20/2016] [Accepted: 04/11/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Paul A. VanderLaan
- Department of Pathology, Beth Israel Deaconess Medical Center; Harvard Medical School; Boston Massachusetts
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23
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Ahn D, Sohn JH, Yeo CK, Jeon JH. Feasibility of surgeon-performed ultrasound-guided core needle biopsy in the thyroid and lymph nodes. Head Neck 2015; 38 Suppl 1:E1413-8. [DOI: 10.1002/hed.24235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine; Kyungpook National University; Daegu Korea
| | - Jin Ho Sohn
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine; Kyungpook National University; Daegu Korea
| | - Chang Ki Yeo
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine; Keimyung University; Daegu Korea
| | - Jae Han Jeon
- Department of Endocrinology, School of Medicine; Kyungpook National University; Daegu Korea
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