title: Randomized comparison of power Doppler ultrasound-directed excisional biopsy with standard excisional biopsy for the characterization of lymphadenopathies in patients with suspected lymphoma.
abstract: OBJECTIVE
  The sensitivity of lymph node excisional biopsy requires validation. Power Doppler ultrasound (US) helps predict the malignant status of lymphadenopathies. We used power Doppler US to select for biopsy the lymph node most suspected of malignancy.
  
  
  METHODS
  One hundred fifty-two patients having lymphadenopathies with clinical suspicion of lymphoma were divided into two well-matched groups and randomly assigned to undergo either standard or power Doppler US-directed lymph node excisional biopsy.
  
  
  RESULTS
  Histology showed a malignancy in 64% of patients in the standard group (lymphoma, 49 patients; carcinoma, two patients) and in 87% of patients in the US-assisted group (lymphoma, 62 patients; carcinoma, one patient). There were significantly fewer biopsy-related complications in the assisted group than in the standard group. During the follow-up of the patients with lymph nodes reported as being reactive, 14 of 29 patients in the standard group were rebiopsied and were found to have lymphoma (13 patients) or carcinoma at the subsequent lymph node histology, whereas none of the patients in the assisted group (nine patients) required a second biopsy. Thus, biopsy provided false-negative results for malignancy in 21% of patients affected by lymphoma in the standard group and never in the assisted group (P <.01).
  
  
  CONCLUSIONS
  Power Doppler US is an accurate tool for screening lymphadenopathies to be removed by excisional biopsy in patients with suspected lymphoma.
authors.affiliation: Department of Clinical and Experimental Medicine, CEINGE-Biotecnologie Avanzate, Federico II University Medical School, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Picardi
authors.forename: Nicola
authors.initials: N
authors.lastname: Gennarelli
authors.forename: Rosanna
authors.initials: R
authors.lastname: Ciancia
authors.forename: Amalia
authors.initials: A
authors.lastname: De Renzo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciancia
authors.forename: Lucianna
authors.initials: L
authors.lastname: Sparano
authors.forename: Pio
authors.initials: P
authors.lastname: Zeppa
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Martinelli
authors.forename: Guido
authors.initials: G
authors.lastname: Pettinato
authors.forename: Roberto
authors.initials: R
authors.lastname: Lobello
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pane
authors.forename: Bruno
authors.initials: B
authors.lastname: Rotoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology* / Q000473:pathology*; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*