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Formulating a Treatment Plan in Suspected Lymphoma: Ultrasound‐Guided Core Needle Biopsy Versus Core Needle Biopsy and Fine‐Needle Aspiration of Peripheral Lymph Nodes
Author(s) -
Drylewicz Monica R.,
Watkins Marcus P.,
Shetty Anup S.,
Lin Michael F.,
Salter Amber,
Bartlett Nancy L.,
Middleton William D.,
Yano Motoyo
Publication year - 2019
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14724
Subject(s) - medicine , biopsy , lymphoma , fine needle aspiration , radiology , lymph node , context (archaeology) , pathology , paleontology , biology
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. χ 2 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.