Interventional radiology techniques for the diagnosis of lymphoma or leukemia.
BACKGROUND
Fluid aspiration, percutaneous biopsy, and catheter drainage are standard minimally invasive methods of diagnosing lymphoma or leukemia in adults.


OBJECTIVE
To determine the effectiveness of interventional radiologic techniques in diagnosing specific hematologic malignancies in children.


METHODS
During a 4-year period, 22 patients (16 male, 6 female; median age, 13 years) underwent 25 percutaneous biopsies, 6 fluid aspirations, 3 catheter drainages, and 1 needle localization for diagnosing suspected hematologic malignancy.


RESULTS
For Hodgkin's disease, the procedures yielded 6 true-positive (TP) results, 2 true-negative (TN) results, and 2 false-negative (FN) results; for non-Hodgkin lymphoma (NHL), 14 TP results, 1 TN result, and 3 FN results; and for leukemia, 4 TP results and 3 FN results. Percutaneous biopsies yielded 16 TP results, 3 TN results, and 6 FN results. Aspirations and drainages yielded 8 TP results and 1 FN result. The one needle localization yielded a FN result. Overall sensitivity was 75%+/-7.3%; specificity, 100%; and accuracy, 77%+/-7.1%.


CONCLUSIONS
Percutaneous biopsy of lymphoma is usually diagnostic. Drainage or aspiration of a fluid collection associated with NHL or leukemia is often diagnostic and is less invasive than biopsy. These procedures are minimally invasive and effective for diagnosing pediatric hematologic malignancies.
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 332 North Lauderdale Street, Memphis, TN 38105-2794, USA.
Kevin M
KM
Garrett
Fredric A
FA
Hoffer
Frederick G
FG
Behm
Kenneth W
KW
Gow
Melissa M
MM
Hudson
John T
JT
Sandlund
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004322:Drainage; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008223:Lymphoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D015642:Radiology, Interventional; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional