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Harikrishnan T, Lalita S, Azariah E, Chandrasekaran D. Tru-cut needle biopsy: A novel approach in the diagnosis of solid oral pathologies. J Oral Maxillofac Pathol 2023; 27:S85-S90. [PMID: 37082287 PMCID: PMC10112698 DOI: 10.4103/jomfp.jomfp_212_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/03/2022] [Indexed: 03/16/2023] Open
Abstract
Nowadays, new biopsy techniques such as fine and wide needles are now employed instead of invasive biopsy techniques. Compared to open biopsy, true-cut needle biopsy has a number of advantages. It's quick and simple to do, can be done in an outpatient department, avoids incisions into previously irradiated skin, and has few risks. In order to examine malignant and benign tumours, there had been a debate in the past century on the utilisation and efficiency of tru-cut biopsy over Fine needle aspiration cytology (FNAC) and surgical biopsy in solid tumours. A non-odontogenic tumour that occurs in jaws, also classified as a fibro-osseous lesion of the jaw, is Cemento-Ossifying Fibroma. Clinically, these lesions occur as gradually growing, reaching an enormous size if not treated. In this article, a case of cemento-ossifying fibroma noticed in the maxilla with facial swelling is discussed and the diagnosis was done using a tru-cut needle biopsy.
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Syrykh C, Chaouat C, Poullot E, Amara N, Fataccioli V, Parrens M, Traverse-Glehen A, Molina TJ, Xerri L, Martin L, Dubois R, Lacheretz-Szablewski V, Copin MC, Moreau A, Chenard MP, Cabarrou B, Lusque A, Gaulard P, Brousset P, Laurent C. Lymph node excisions provide more precise lymphoma diagnoses than core biopsies: a French Lymphopath network survey. Blood 2022; 140:2573-83. [PMID: 35797472 DOI: 10.1182/blood.2022015520] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/24/2022] [Accepted: 06/14/2022] [Indexed: 11/20/2022] Open
Abstract
According to expert guidelines, lymph node surgical excision is the standard of care for lymphoma diagnosis. However, core needle biopsy (CNB) has become widely accepted as part of the lymphoma diagnostic workup over the past decades. The aim of this study was to present the largest multicenter inventory of lymph nodes sampled either by CNB or surgical excision in patients with suspected lymphoma and to compare their diagnostic performance in routine pathologic practice. We reviewed 32 285 cases registered in the French Lymphopath network, which provides a systematic expert review of all lymphoma diagnoses in France, and evaluated the percentage of CNB and surgical excision cases accurately diagnosed according to the World Health Organization classification. Although CNB provided a definitive diagnosis in 92.3% and seemed to be a reliable method of investigation for most patients with suspected lymphoma, it remained less conclusive than surgical excision, which provided a definitive diagnosis in 98.1%. Discordance rates between referral and expert diagnoses were higher on CNB (23.1%) than on surgical excision (21.2%; P = .004), and referral pathologists provided more cases with unclassified lymphoma or equivocal lesion through CNB. In such cases, expert review improved the diagnostic workup by classifying ∼90% of cases, with higher efficacy on surgical excision (93.3%) than CNB (81.4%; P < 10-6). Moreover, diagnostic concordance for reactive lesions was higher on surgical excision than CNB (P = .009). Overall, although CNB accurately diagnoses lymphoma in most instances, it increases the risk of erroneous or nondefinitive conclusions. This large-scale survey also emphasizes the need for systematic expert review in cases of lymphoma suspicion, especially in those sampled by using CNB.
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Kamran M, Wallace AN, Adewumi A. Interventional Management of Head and Neck Tumors. Semin Intervent Radiol 2020; 37:157-165. [PMID: 32419728 DOI: 10.1055/s-0040-1709157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Advancements in medical imaging and device technology allow minimal invasive procedures for the diagnosis and treatment of various disorders. For the management of tumors in head and neck region, these image-guided interventions play essential role in the often used multidisciplinary approach. Tissue sampling under ultrasound or computed tomography guidance is generally the first step to reach a pathological diagnosis. For head and neck tumors with high vascularity, embolization using particulate matter, liquid embolic agents, or coils is used to achieve successful tumor resection with minimal blood loss. Hemorrhage related to head and neck tumors can be evaluated and managed with endovascular techniques with minimal morbidity and mortality. Intra-arterial chemotherapy, radiofrequency ablation, and cryotherapy are new techniques for the management of advanced head and neck cancer which may serve as an alternative to achieve locoregional control and survival when curative resection may not be feasible.
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Affiliation(s)
- Mudassar Kamran
- Department of Radiology, UAMS College of Medicine, Little Rock, Arkansas
| | - Adam N Wallace
- Department of Neurointerventional Surgery, Ascension Columbia St. Mary's Hospital, Milwaukee, Wisconsin
| | - Amole Adewumi
- Department of Radiology, UAMS College of Medicine, Little Rock, Arkansas
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Abstract
Image-guided interventional procedures provide a safe way to diagnose and treat a variety of head and neck abnormalities. The procedure time is usually short, and most procedures can be performed on an outpatient basis. Knowledge about strengths and weaknesses, efficacy, potential complications, and pitfalls of these procedures allows the best treatment to be chosen for a particular lesion type. This review discusses some of the commonly performed interventional radiology procedures in a general radiology department in the management of patients with neoplastic diseases in the head and neck region.
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Affiliation(s)
- H Y Yuen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
| | - Y Y P Lee
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
| | - K Bhatia
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
| | - A T Ahuja
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
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Yuen HY, Lee Y, Bhatia K, Wong KT, Ahuja AT. Use of end-cutting needles in ultrasound-guided biopsy of neck lesions. Eur Radiol 2011; 22:832-6. [PMID: 22080282 DOI: 10.1007/s00330-011-2323-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 09/28/2011] [Accepted: 10/20/2011] [Indexed: 12/20/2022]
Abstract
UNLABELLED The management of a neck mass is dictated by its nature, location and extent. Pathological diagnosis by fine needle aspiration cytology (FNAC) or core biopsy is often required before proceeding to definitive treatment. It is not uncommon for the cytology result to come back as inadequate for various reasons. The unique design of the end-cutting biopsy needle in our experience makes it a good choice for use in obtaining both transcutaneous and intraoral biopsy under ultrasound guidance of neck lesions and serves as a useful alternative or adjunct to FNAC. Although there is, as yet, only a limited evidence base about end-cutting in comparison to side-cutting needles, they carry several potential advantages. KEY POINTS End-cutting needles are safe to use for lesions close to vital structures. End-cutting needles yield sufficient tissue samples in a single pass. End-cutting biopsy needles are a useful adjunct to FNAC.
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Affiliation(s)
- H Y Yuen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
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Novoa E, Gürtler N, Arnoux A, Kraft M. Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck 2011; 34:1497-503. [PMID: 22127851 DOI: 10.1002/hed.21821] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2011] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Core-needle biopsy (CNB) has occasionally been used in the work-up of head and neck lesions. However, no systematic review of this simple, minimally invasive method has yet been performed. METHODS A systematic review of the literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1291 cervical lesions in 1267 patients were examined by CNB. This resulted in 1232 adequate samples, from which 554 were subsequently confirmed by excisional biopsy. RESULTS CNB was able to identify true neoplasms and detect malignancy in head and neck lesions with an overall accuracy of 94% and 96%, respectively, even though there was a significant difference between the histologically verified and all adequate samples. CNB provided a correct specific diagnosis in 87% of cases without major complications and achieved a higher accuracy than that of fine-needle aspiration in detecting malignancy. CONCLUSIONS This meta-analysis confirms that CNB is an excellent method in the assessment of salivary gland lesions and lymphadenopathies inclusive of malignant lymphoma, but it is not ideal for evaluating thyroid lesions.
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Affiliation(s)
- Eva Novoa
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital AG, Aarau, Switzerland.
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Dos Santos JAR, Capella DL, Rozza RE, Ferreira SJ, Berti-Couto SDA, Sant'ana-Filho M, de Lima AAS, Westphalen FH, Couto-Souza PH. Histological diagnosis of oral lesions with cutting needle biopsy: a pilot study. J Oral Maxillofac Res 2011; 2:e3. [PMID: 24421990 PMCID: PMC3886060 DOI: 10.5037/jomr.2011.2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 04/18/2011] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this pilot study was to evaluate the effectiveness of cutting
needle biopsy in the diagnosis of solid oral lesions. Material and Methods The biopsies were carried out on seven patients who presented with solid oral
lesions with sizes ranging from 2 to 6 cm. Specimens were obtained from each
lesion before conventional biopsies using a cutting needle with 18-gauge x 9
cm (MD TECH, Gainesville, FL, USA). A total of 64 specimens processed by
hematoxylin-eosin staining method, were obtained. Afterwards, the analysis
was performed by an oral pathologist, in two different stages, with and
without the clinical history of each lesion. Then, these answers were
compared with the final histological diagnosis. Results Results presented by the descriptive analysis showed that the correct
diagnosis using cutting needle biopsy without the clinical history of
lesions was registered in 37.5% of cases, while with the clinical history in
76.6%. Conclusions Despite the promising results as a potential technique for biopsies and
histological diagnosis of oral lesions, the cutting needle biopsy should be
analyzed carefully in those cases.
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Affiliation(s)
| | - Diogo Lenzi Capella
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Paraná Brazil
| | - Rafaela Elvira Rozza
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Paraná Brazil
| | | | | | - Manoel Sant'ana-Filho
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul Brazil. ; Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul Brazil
| | | | - Fernando Henrique Westphalen
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Paraná Brazil. ; Department of Stomatology, School of Dentistry, Federal University of Paraná Brazil
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Saha S, Woodhouse NR, Gok G, Ramesar K, Moody A, Howlett DC. Ultrasound guided Core Biopsy, Fine Needle Aspiration Cytology and Surgical Excision Biopsy in the diagnosis of metastatic squamous cell carcinoma in the head and neck: an eleven year experience. Eur J Radiol 2010; 80:792-5. [PMID: 21093189 DOI: 10.1016/j.ejrad.2010.10.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 10/12/2010] [Accepted: 10/20/2010] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study aims to review our 11 year experience of diagnosing metastatic squamous cell carcinoma presenting as head and neck lumps. The techniques of Ultrasound guided Core Biopsy (USCB), Fine Needle Aspiration Cytology (FNAC) and Surgical Excision Biopsy (SEB) are compared. MATERIALS AND METHODS All patients with metastatic squamous cell carcinoma (SCC) involving the lymph nodes of the head and neck or parotid gland, diagnosed at Eastbourne District General Hospital between January 1998 and November 2009 were identified. The following data items were collated: biopsy location (e.g. cervical lymph node or parotid), any history of likely primary SCC and site, type of biopsy used to establish a conclusive diagnosis (index diagnostic technique), previous biopsies, the technique and their results, subsequent histology results. RESULTS A total of 90 patients were diagnosed with metastatic squamous cell carcinoma. The index diagnostic technique was USCB in 48 patients, FNAC in 29 and SEB in 13. In 72 (80%) patients the index biopsy was the sole tissue sample taken prior to surgery or other treatment. The remaining 18 patients underwent a total of 22 previous biopsies prior to the index biopsy. 95% (21/22) of these previous biopsies were non-definitive FNAC and 5% (1/22) was a non-definitive USCB. FNACs also demonstrated the highest non-diagnostic rate (42%). The accuracy of USCB and FNAC in correlating with final histopathology was 97% and 85% respectively. CONCLUSIONS USCB demonstrates excellent results in the diagnosis of metastatic SCC in the head and neck with higher accuracy and greater reliability than FNAC.
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Affiliation(s)
- Shouvik Saha
- Department of Radiology, Eastbourne District General Hospital, United Kingdom.
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Pfeiffer J, Kayser G, Ridder GJ. Sonography-assisted cutting needle biopsy in the head and neck for the diagnosis of lymphoma: Can it replace lymph node extirpation? Laryngoscope 2009; 119:689-95. [DOI: 10.1002/lary.20110] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Carbone A, Ferlito A, Devaney KO, Rinaldo A. Ultrasound-guided core-needle biopsy: is it effective in the diagnosis of suspected lymphomas presenting in the head and neck? J Surg Oncol 2008; 98:4-5. [PMID: 18338333 DOI: 10.1002/jso.21003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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