Laparoscopic lymph node biopsy in the diagnosis of lymphoma. Indications and results.
BACKGROUND
Exclusive abdominal nodal involvement due to Hodgkin or non Hodgkin lymphoma (HL,NHL) is a rare condition, but its occurrence requires a good enough specimen for diagnosis and therapy. Aim of this work is to evaluate the results of laparoscopic lymph node biopsy (LLNB) in a series of patients where a primitive or relapsing lymphoma was suspected.


METHODS
This study has been carried on the patients submitted to LLNB from 2007 to 2011. Cases records were retrospectively reviewed for age, sex, diagnostic work up, previous biopsy, conversion to laparotomy, pathologic diagnosis and perioperative complications.


RESULTS
Eleven cases were evaluated including 4 males and 7 females; mean age was 56.5 years. All patients underwent Ultrasound (US) and CT scan. A previous US or CT guided biopsy was performed in 5 cases, but in all of them failed to obtain a diagnosis. LLNB was successfully performed in 8 cases and required a conversion in three. Causes of conversion were obesity in one case and previous surgery in two. Results of pathology were NHL 5 cases, HL 2, follicular hyperplasia 2, sarcoidosis and tuberculosis 1 case respectively. No mortality nor morbidity occurred. Mean hospital stay was of 2.7 days.


CONCLUSIONS
LLNB proved to be a safe procedure with no perioperative complications. Laparoscopy however should not be undertaken if superficial lymphadenopathy is present. A thorough CT evaluation of abdominal nodal involvement by the surgical team is mandatory prior to laparoscopy in order to plan the surgical approach and the route to reach the node.
Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università degli Studi, Cagliari. gpisano@unica.it
Giuseppe
G
Pisano
Pietro Giorgio
PG
Calò
Stefano
S
Piras
Sandro
S
Sanna
Alessandro
A
Manca
Alberto
A
Tatti
Angelo
A
Nicolosi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008198:Lymph Nodes / Q000473:pathology*; D008223:Lymphoma / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies