title: Ultrasound-guided core biopsy in the diagnosis of lymphoma of the head and neck. A 9 year experience.
abstract: OBJECTIVE
  This retrospective study aimed to evaluate the diagnostic utility of ultrasound-guided core biopsy (USCB) in lymphoma of the head and neck, in particular whether core biopsy can provide sufficient diagnostic information for definitive treatment.
  
  
  METHODS
  All lymphomas diagnosed in the head and neck at Eastbourne General Hospital between January 2000 and June 2009 were identified. Radiology and pathology reports were reviewed and the diagnostic techniques recorded. The type of biopsy (fine needle aspiration, needle core, surgical excision biopsy) used to establish a diagnosis sufficient to allow treatment, i.e. the "index" diagnostic technique, was identified. Previous inconclusive or inadequate biopsies were noted. Pathology reports based on USCB were graded 0-3 according to diagnostic completeness and ability to provide treatment information.
  
  
  RESULTS
  Of 691 overall cases of lymphoma diagnosed over the 9 year period, 171 different patients presented with lymphoma in the head and neck. Of these 171, 83 had USCB biopsy during diagnostic work up. 60 were regarded as grade 3 where a confident diagnosis of lymphoma was made. In seven patients, clinical management proceeded on the basis of a suggestive (grade 2) pathology report without surgical excision, and these were therefore also included as "index" biopsies. Overall therefore, 67/83 core biopsies (81%) provided adequate information to allow treatment. Surgical excision biopsy was the index modality in 104 cases.
  
  
  CONCLUSIONS
  In the majority of cases USCB is adequate for confident histopathological diagnosis avoiding the need for surgical excision biopsy in cases of suspected head and neck lymphoma.
authors.affiliation: Department of Radiology, Eastbourne District Hospital, East Sussex, UK. drchristopherburke@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Burke
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: C
authors.initials: C
authors.lastname: Inglis
authors.forename: A
authors.initials: A
authors.lastname: Baldwin
authors.forename: K
authors.initials: K
authors.lastname: Ramesar
authors.forename: R
authors.initials: R
authors.lastname: Grace
authors.forename: D C
authors.initials: DC
authors.lastname: Howlett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008223:Lymphoma / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*