Accuracy and cost-effectiveness of core needle biopsy in the evaluation of suspected lymphoma: a study of 101 cases.
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.
Lachar
Whitney A
WA
Department of Pathology, Baylor University Medical Center, Dallas, Tex, USA.
Shahab
Imran
I
Saad
A Joe
AJ
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
D015703:Antigens, CD