title: Use of percutaneous image-guided coaxial core-needle biopsy for diagnosis of intraabdominal lymphoma.
abstract: Although pathological diagnosis is essential for managing malignant lymphoma, intraabdominal lesions are generally difficult to approach due to the invasiveness of abdominal surgery. Here, we report the use of percutaneous image-guided coaxial core-needle biopsy (CNB) to obtain intraabdominal specimens for diagnosing intraabdominal lymphomas, which typically requires histopathological and immunohistochemical evaluation. We retrospectively reviewed consecutive cases involving computed tomography (CT)- or ultrasonography (US)-guided CNB to obtain pathological specimens for intraabdominal lesions from 1999 to 2011. Liver, spleen, kidney, and inguinal node biopsies were excluded. We compared CNBs with laparotomic biopsies. A total of 66 CNBs were performed for 59 patients (32 males, 27 females; median age, 63.5), including second or third repeat procedures. Overall diagnostic rate was 88.5%. None of the patients required additional surgical biopsies. Notably, the median interval between recognition of an intraabdominal mass and biopsy was only 1 day. Forty-five procedures were performed for hematological malignancies. Adequate specimens were obtained for histopathological diagnosis in 86% of cases. Flow cytometry detected lymphoma cells in 79.5% of cases. Twelve patients (nine males, three females; median age, 60) were eligible for surgical biopsy. While every postoperative course was satisfactory, median duration from lesion recognition to therapy initiation for lymphoma cases was significantly shorter for CNB than for surgical biopsy (14 vs. 35 days). While one-fourth of the patients were not eligible for the procedures, CNB is safe and highly effective for diagnosis of intraabdominal lymphomas. This method significantly improves sampling and potentially helps attain immunohistological distinction, allowing for more timely therapy initiation.
authors.affiliation: Department of Hematology, Nagano Red Cross Hospital, Nagano-city, Nagano, Japan; Center for Medical Education, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Shimizu
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Wataru
authors.initials: W
authors.lastname: Takeda
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kirihara
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fujikawa
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Ueki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hiroshima
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sumi
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ueno
authors.forename: Naoaki
authors.initials: N
authors.lastname: Ichikawa
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D000008:Abdominal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002871:Chromosome Banding; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D016130:Immunophenotyping; D008223:Lymphoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Diagnosis; immunophenotype; malignant lymphoma; needle biopsy; sensitivity and specificity