title: Ultrasound-guided core biopsy in the diagnostic work-up of tuberculous lymphadenitis in Saudi Arabia, refining the diagnostic approach. Case series and review of literature.
abstract: OBJECTIVE
  Tuberculous cervical lymphadenitis is the most common presentation of extrapulmonary tuberculosis (TB) in Saudi Arabia and worldwide. Obtaining a tissue biopsy for culture and histopathology is frequently needed to establish the diagnosis. The available diagnostic tools include excisional surgical biopsy, fine needle aspiration (FNA) and ultrasound-guided core lymph node biopsy. We present a single center experience of the use of ultrasound-guided core lymph node biopsy as a diagnostic tool for tuberculous lymphadenitis.
  
  
  METHODS
  A retrospective review of the interventional radiology database for all of the patients with cervical lymphadenopathy undergoing ultrasound-guided core biopsy at King Abdulaziz Medical City-Riyadh, Saudi Arabia from January 1 2008 to December 30 2011. The data were the patient demographics, clinical characteristics, biopsy method and pathological and clinical diagnoses.
  
  
  RESULTS
  Five cases underwent ultrasound-guided cervical lymph node biopsy during the study period. A total of 55 cases underwent excisional cervical lymph node biopsy in the same period. The age of the patients who underwent the core biopsy ranged from 18 to 76 years old. All of the biopsies were performed as one-day surgery, and all of the patients were discharged on the same day with no complications. The final diagnosis was confirmed in all of the cases (100%); with tuberculosis being the diagnosis in four of the five cases (80%), and one case being diagnosed as lymphoma.
  
  
  CONCLUSIONS
  Ultrasound-guided core biopsy is an underutilized procedure in our hospital and could be a very valuable asset in the diagnostic algorithm of tuberculous lymphadenitis in Saudi Arabia. The widespread use of the procedure would positively affect patient care, providing earlier diagnosis and treatment.
authors: College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors: Othman
authors: O
authors: Altuwairgi
authors: College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: baharoon@hotmail.com.
authors: Salim
authors: S
authors: Baharoon
authors: Infectious Diseases, King Khalid University Hospital, Riyadh, Saudi Arabia.
authors: Yosra
authors: Y
authors: Alkabab
authors: King Saud Chest Specialty Hospital, Riyadh, Saudi Arabia.
authors: Eiman
authors: E
authors: Alsafi
authors: Medical Imaging, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors: Mohammed
authors: M
authors: Almoweqel
authors: College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors: Hamdan
authors: H
authors: A L-Jahdali
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008198:Lymph Nodes / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012529:Saudi Arabia; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis*; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
keywords: Ultrasound-guided biopsy; Ultrasound-guided core biopsy; Ultrasound-guided lymph node biopsy