CT-guided core-needle biopsy in omental pathology.
OBJECTIVE
To assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology.


METHODS
We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n = 2) or diffuse (n = 23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n = 15), laparoscopic biopsy (n = 3), endoscopic biopsy (n = 1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n = 6). The final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. The CT-guided biopsies were performed with 1.0-1.8-mm Surecut core-needles.


RESULTS
In 16 patients, the final diagnosis was metastatic adenocarcinoma--with the primary tumor sites in the ovary (n = 3), stomach (n = 1), appendix (n = 2), and unknown (n = 10). In the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n = 16) or cytological (n = 8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. In differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications.


CONCLUSIONS
CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology.
Pombo
F
F
Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain.
Rodriguez
E
E
Martin
R
R
Lago
M
M
D000196:Actinomycosis / Q000473:pathology; D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001063:Appendiceal Neoplasms / Q000473:pathology; D001431:Bacteriological Techniques; D001706:Biopsy / Q000379:methods; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000556:secondary; D004724:Endoscopy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008223:Lymphoma / Q000473:pathology; D008297:Male; D008654:Mesothelioma / Q000473:pathology; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000473:pathology; D009852:Omentum / Q000382:microbiology / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology; D010532:Peritoneal Diseases / Q000382:microbiology / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000473:pathology*; D014395:Peritonitis, Tuberculous / Q000473:pathology; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology; D014057:Tomography, X-Ray Computed