title: Accuracy and cost-effectiveness of core needle biopsy in the evaluation of suspected lymphoma: a study of 101 cases.
abstract: BACKGROUND
  Lymphomas have traditionally been diagnosed on excisional biopsies of lymph nodes in order to evaluate tissue architecture and cytomorphology. Recent lymphoma classification schemes emphasize immunophenotypic, genetic, and molecular aspects in addition to morphology as diagnostic features. Core needle biopsies are increasingly being used to obtain tissue for diagnosis in patients with lymphadenopathy and a clinical suspicion of lymphoma. These procedures are rapid, minimally invasive, well tolerated, and may provide some architectural framework (unlike fine-needle aspirations), as well as material for ancillary studies.
  
  
  OBJECTIVE
  To explore the accuracy, utility, and cost-effectiveness of this technique.
  
  
  METHODS
  Core needle biopsies of 101 consecutive patients from 2 large community hospitals who were suspected of having primary or recurrent lymphomas were retrospectively reviewed. All patients had hematoxylin-eosin-stained sections of needle cores. Specimens morphologically suspicious for lymphoma were subjected to ancillary studies, including immunohistochemistry, flow cytometry, and/or molecular studies. Core needle biopsy diagnoses were correlated with subsequent excisional biopsies, if performed.
  
  
  RESULTS
  Core needle biopsies established a definitive pathologic diagnosis for the vast majority of cases. A diagnosis was considered sufficient to begin treatment for primary and recurrent lymphomas in most cases. Compared with an open biopsy, there is a cost savings of greater than 75%.
  
  
  CONCLUSIONS
  The accuracy of this technique, along with the cost savings and decreased morbidity, suggest that this method may be used safely and reliably as a first-line diagnostic technique.
authors.affiliation: Department of Pathology, Baylor University Medical Center, Dallas, Tex, USA.
authors.forename: Whitney A
authors.initials: WA
authors.lastname: Lachar
authors.forename: Imran
authors.initials: I
authors.lastname: Shahab
authors.forename: A Joe
authors.initials: AJ
authors.lastname: Saad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis; D001707:Biopsy, Needle / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007150:Immunohistochemistry; D008223:Lymphoma / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D015703:Antigens, CD