Peripheral compressing artifacts in brain tissue from stereotactic biopsy with sidecutting biopsy needle: a pitfall for adequate glioma grading.
OBJECTIVE
The stereotactic brain biopsy is an essential diagnostic procedure in modern neurologic patient management. A side-cutting biopsy needle is one of the most widely used needle types. Recently we found a characteristic tissue artifact named "peripheral compressing artifact" in the brain tissues biopsied using a side-cutting needle of Leksell's system. We investigate prevalence, possible cause and its clinical implication of this type of artifact.


METHODS
We examined the biopsies from 80 patients (44 cases of gliomas, 13 lymphomas, 7 germ cell tumors, 2 other tumors, 1 metastatic carcinoma, 4 non-tumorous conditions such as demyelinating disease and 8 non-diagnostic) in the stereotactic biopsy group with a suspected brain tumor, who underwent a stereotactic brain biopsy using side-cutting needle of Leksell's system. We also evaluated 16 cases of open brain biopsies without Leksell's system as a control group.


RESULTS
The artifact is a semi-circular or band-like tissue compression in the periphery of the biopsied tissue. This artifact was found in 30 (37.5%) out of 80 cases and 57 (11.9%) out of 477 biopsied pieces. It might be produced during rotating of the inner cannula of the biopsy needle. Histologically, it might be misinterpreted as "hypercellular", "spindle", "well circumscribed", or rarely as "pseudopalisading" especially in glioma.


CONCLUSIONS
Awareness of this artifact would help making the appropriate pathological diagnosis for glioma.
Departments of Pathology and Neurosurgery, Neuro-Oncology Clinic and Brain Research Institute, Yonsei University College of Medicine, Seoul, Department of Neurology, Hallym University, Chuncheon, and Department of Pathology, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
S H
SH
Kim
W S
WS
Chang
J P
JP
Kim
Y K
YK
Minn
J
J
Choi
J W
JW
Chang
T S
TS
Kim
Y G
YG
Park
J H
JH
Chang
D016477:Artifacts; D001706:Biopsy; D001921:Brain; D001932:Brain Neoplasms; D005910:Glioma; D006801:Humans; D009339:Needles; D013238:Stereotaxic Techniques