Ultrasound-Guided Core Needle Biopsy of Cervical Lymphadenopathy in Patients with Lymphoma: The Clinical Efficacy and Factors Associated with Unsuccessful Diagnosis (original) (raw)
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Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2020
Objective: This study was conducted to assess the effectiveness of Ultrasound-guided Core Needle Biopsy (US-CNB) to provide sufficient information for diagnosis and initiation of the treatment for head and neck lymphoma. Study Design: We carried out the prospective consecutive case series in a single-center study. Setting: The tertiary medical center setting. Patients and Methods: Totally, 72 patients were enrolled and the US-CNB of suspicious cervical lymph node was performed. Demographics, imaging and pathological data were collected for each patient and used to identify the factors that shape the diagnostic yield of US-CNB. Results: We observed among 72 CNBs 52 were fully diagnosed and 20 cases needed Excisional Surgical Biopsy for subclassification. Then the factors influencing the results of the US-CNB, as the first-line diagnostic procedure for suspected cervical lymphadenopathy were discussed. The CNB results did not differ in terms of BMI, neck circumference and pathological subtype. Fully diagnosis CNB results demonstrated an association with higher mean tumor size and LAP in cervical zones 1 to 4 rather than posterior triangle. Conclusion: About 30% of the patients in the present study required ESB after US-CNB for fully diagnosis and this delayed their treatment. Therefore, the use of US-CNB as a primary method in assessment of cervical lymphadenopathy still needs more studies to investigate the factors influencing the results and shaping its diagnostic yield.
Core needle biopsy for diagnosing lymphoma in cervical lymphadenopathy: Meta‐analysis
Head & Neck, 2020
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.
The turkish journal of ear nose and throat, 2023
Objective: Diagnosis of axillary nodal involvement is significant in the management of breast cancer as well as in predicting prognosis. In this prospective study, we evaluated the efficiency of US-guided fine needle aspiration biopsy (FNAB) in preoperative axillary staging of early breast cancer. Material and Methods: Between January 2011 and July 2013, 46 women were prospectively enrolled in the study. Ultrasound guided-FNABs for axillary assessment were performed preoperatively. Cytology results were compared with histopathology reports to determine its sensitivity, specificity, negative and positive predictive value and accuracy. Results: Nineteen cases that had malignant cytology on FNAB also had axillary involvement in axillary lymph node dissection (ALND) without any false-positive results. The sensitivity and specificity of US-guided FNAB were 63.3% and 100%, respectively. US-guided FNAB was accurate in predicting the status of the axilla in 76.1% of patients. Conclusion: Although this technique is favorable due to its minimally invasive nature, it is not as effective as sentinel lymph node biopsy (SLNB) in terms of detecting axillary metastasis preoperatively. The low sensitivity and low accuracy rates decrease the usefulness of the technique. Therefore, it seems that US-guided FNAB alone could not replace SLNB. Nevertheless, combining some other molecular studies may be useful in increasing the technique's sensitivity. These issues should be determined by comprehensive clinical trials.
Role of fine needle aspiration cytology in assessment of cervical lymphadenopathy
Medical Journal of Dr. D.Y. Patil University, 2013
Background: Lymphadenopathy is one of the commonest clinical presentations of patients attending the outdoor department. The causes vary from simple treatable infections to malignancies and hence need to be speedily investigated. Fine needle aspiration cytology (FNAC) is simple, quick, inexpensive and minimally invasive technique that can be used as an outpatient procedure to diagnose them. The Aim and objective of this study is to assess the various causes of cervical lymphadenopathy through FNAC, and to see the distribution of lesions with respect to age and gender. Method: The present randomized study was undertaken to study non neoplastic and neoplastic lesions of enlarged cervical lymph nodes by FNAC in 135 patients presented with cervical lymphadenopathy in Shree Krishna Hospital, Karamsad over a period of March 2006 to June 2007. Result: Tuberculous lymphadenitis, reactive lymphadenopathy, suppurative lymphadenitis, lymphoma, leukemic infiltration and metastatic lymphadenopathy were seen in 38.52%, 24.45.%, 3.70%, 2.22%, 0.74% and 30.37% respectively. Tuberculous lymphadenitis was seen most often in third decade and reactive hyperplasia in first two decades of life. Metastatic lymphadenopathy was seen predominantly above forty years of age. Metastatic lesions of lymph nodes were seen to be more common in males. Squamous cell carcinoma is the most common metastatic lesion. Conclusion: The present study highlights the usefulness of FNAC in early diagnosis in cases presenting with cervical lymphadenopathy. It can differentiate a neoplastic from a non-neoplastic process and therefore influence the patient management and prevent them from being subjected to unnecessary surgery.