Ultrasound-guided core needle biopsy of superficial lymph nodes: an alternative to fine-needle aspiration cytology for the diagnosis of lymph node metastasis in cutaneous melanoma.
To investigate the diagnostic value of ultrasound-guided core needle biopsy (US-CNB) in suspected cases of lymph node metastasis from cutaneous melanoma. All patients with cutaneous melanoma followed in Saint-Louis Hospital between 2006 and 2010 who underwent US-CNB for suspicion of melanoma lymph node metastasis were reviewed retrospectively. Histopathological results of US-CNB samples were classified as melanoma, other malignancy, suspicious, inadequate, or benign. The diagnostic accuracy of US-CNB was assessed by comparison with two reference standards: histopathological examination of the radical lymph node dissection or, when this was not available, clinical and radiological follow-up. The data from 72 US-CNB were analyzed. Forty-four melanomas, 22 benign, three other malignancies, three inadequate samples, and no inconclusive specimens were diagnosed. Seventy-one US-CNB results were confirmed (98.6%). US-CNB achieved high sensitivity, specificity, and positive predictive value (respectively, 97.9, 100, and 100%). No adverse events were reported after the procedure. US-CNB provided a mean tissue volume of 16.7 mm per lymphadenopathy. US-CNB has diagnostic value similar to that of fine-needle aspiration cytology. It represents a reliable alternative method in melanoma lymph node metastasis to avoid surgery in patients who will not benefit from it. US-CNB provides relatively large samples of tissue suitable for comprehensive genomic analyses currently needed for research and personalized care of melanoma patients.
aAP-HP, Oncodermatology Unit, Dermatology Department bAP-HP, Pathology Department cAP-HP, Radiology Department dAP-HP, Pharmacology-Genetic Laboratory eAP-HP, Department of Biostatistics and Medical Data Processing, Saint-Louis Hospital, Paris 7 Diderot University fParis Diderot University, Sorbonne Paris Cité, UMR-S 728 gParis Diderot University, Sorbonne Paris Cité, UMR 976 hINSERM, U728 iINSERM, U976, Paris, France.
Gérôme
G
Bohelay
Maxime
M
Battistella
Cécile
C
Pagès
Constance
C
de Margerie-Mellon
Nicole
N
Basset-Seguin
Manuelle
M
Viguier
Delphine
D
Kerob
Nika
N
Madjlessi
Michel
M
Baccard
Alain
A
Archimbaud
Christelle
C
Comte
Samia
S
Mourah
Raphael
R
Porcher
Martine
M
Bagot
Anne
A
Janin
Eric
E
De Kerviler
Céleste
C
Lebbé
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology*; D018084:Ultrasonography, Interventional / Q000379:methods*; D055815:Young Adult