title: The Utility of Core Needle Biopsy and Fine-Needle Aspiration in the Workup of Tumors of Suspected Müllerian Origin.
abstract: OBJECTIVE
  Core needle biopsy (CNB) and fine-needle aspiration (FNA) for tumors of suspected Müllerian origin may prevent unnecessary laparotomies and allow patients the benefit of neoadjuvant chemotherapy. An assessment of the utility and limitations of CNB/FNA, with incorporation of current immunohistochemistry, is needed.
  
  
  METHODS
  Two hundred nineteen female patients with CNB/FNA of the omentum, pelvis, abdomen, adnexa, ovary, uterus, and fallopian tube were identified. From these, 30 consecutive CNB/FNA with corresponding surgical resection were reviewed to assess diagnostic agreement and identify potential diagnostic pitfalls.
  
  
  RESULTS
  The most frequent diagnosis overall was adenocarcinoma (96/219; 43.8%), most commonly adenocarcinoma of gynecologic origin (65/219; 30%). Nondiagnostic or unsatisfactory material was present in a minority of cases (10/219; 5%). In the 30 CNB/FNA cases examined for diagnostic agreement with surgical resection, 24 (80%) had exact or essential agreement with the final diagnosis. Of the 23 cases that were positive and/or suspicious on cytology, 18 (78%) had neoadjuvant chemotherapy or radiation treatment prior to surgical resection.
  
  
  CONCLUSIONS
  The majority of CNB/FNA for tumors of suspected Müllerian origin are diagnostic, correlate with the surgical resection, and contribute to management. A standard diagnostic algorithm is suggested.
authors: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Tex., USA.
authors: Suzanne
authors: S
authors: Crumley
authors: Ekene
authors: E
authors: Okoye
authors: Michael
authors: M
authors: Deavers
authors: Donna
authors: D
authors: Coffey
mesh_terms: D000465:Algorithms; D044963:Biopsy, Fine-Needle; D062005:Biopsy, Large-Core Needle; D017024:Chemotherapy, Adjuvant; D019091:Critical Pathways; D003663:Decision Trees; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology* / Q000628:therapy; D006801:Humans; D009095:Mullerian Ducts / Q000473:pathology* / Q000601:surgery; D020360:Neoadjuvant Therapy; D015588:Observer Variation; D011237:Predictive Value of Tests; D018714:Radiotherapy, Adjuvant; D015203:Reproducibility of Results; D012189:Retrospective Studies