Yield and Complications in Ultrasound-Guided Biopsy of Abdominal Lesions

1995 ◽  
Vol 36 (4-6) ◽  
pp. 485-490 ◽  
Author(s):  
R. S. Nyman ◽  
J. Cappelen-Smith ◽  
J. Brismar ◽  
W. von Sinner ◽  
I. Kagevi
Keyword(s):  
Diagnostic Yield ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Benign Disease ◽  
Bleeding Complications ◽  
Benign Lesions ◽  
Ultrasound Guided ◽  
Focal Lesions ◽  
Malignant Lesions ◽  
Abdominal Lesions

A series of 458 consecutive ultrasound-guided biopsies in 347 patients − 171 fine-needle aspiration biopsies (FNABs) and 287 1.2-mm needle core biopsies (NCBs) − was analysed for diagnostic yield and complications. FNAB was diagnostic in 107 (64%) biopsies of focal lesions with a correct diagnosis of malignancy in 86 of 125 biopsies (69%) and of benign disease in 21 of 43 (49%) biopsies. NCB provided a correct diagnosis in 189 (90%) biopsies for focal lesions, divided into 140 of 159 (88%) correct for malignancy and 49 of 50 (98%) correct for benign disease. In 69 patients examined with both FNAB and NCB on the same occasion, 50 out of 55 malignant lesions were identified with NCB but only 34 with FNAB; all 14 benign lesions were correctly identified by NCB, and only 6 by FNAB. Clinical relevant bleeding complications occurred in 6 out of 458 biopsies (1.3%) − 3 out of 287 following NCB (1.0%) and 3 out of 171 following FNAB (1.8%). It is concluded that if FNAB is replaced with 1.2-mm NCB using an automated biopsy gun, the diagnostic accuracy for abdominal lesions increases significantly (p<0.001), while the complication rate remains the same.

The role of laboratory processing in determining diagnostic conclusiveness of breast fine needle aspirations: conventional smearing versus a monolayer preparation

2009 ◽  
Vol 62 (10) ◽  
pp. 931-934 ◽  
Author(s):  
C A P Wauters ◽  
B Kooistra ◽  
L J A Strobbe
Keyword(s):  
Ultrasound Guidance ◽  
Needle Aspiration ◽  
Processing Technique ◽  
Benign Lesions ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Malignant Lesions ◽  
The Difference

Aim:To compare breast fine needle aspiration (FNA) specimens prepared by conventional smearing (CS) versus monolayer preparation (MP), with respect to the conclusiveness of the cytopathological diagnosis.Methods:From 1992 to 1996, aspirators prepared aspirates themselves by direct smearing onto 2–4 slides. From 1999 to 2003, aspirate preparation was performed in the laboratory, creating a MP, using a Hettich cytocentrifuge. FNA diagnoses were categorised into inadequate (C1), benign (C2), atypical (C3), suspicious for malignancy (C4) and malignant (C5). The reference standard constituted histological follow-up. A conclusive FNA diagnosis was defined as C2 in lesions benign on follow-up and C5 in lesions malignant on histology.Results:From 1992 to 1996, 692 aspirates were processed by CS, whereas from 1999 to 2003, 1301 aspirates were processed by MP. More FNA were ultrasound-guided in the MP group (85.6% versus 21.5%, p<0.001). When compared with CS, MP-prepared FNA had conclusive diagnoses significantly more often (72.8% versus 58.5%, p<0.001). This effect remained significant when corrected for the difference in ultrasound guidance (adjusted odds ratio 1.7, 95% confidence interval 1.3 to 2.2, p<0.001), and was larger for malignant lesions than for benign lesions (51.7% versus 79.9%, p<0.001).Conclusion:Patients presenting with breast lesions can more often be offered a same-day, conclusive cytopathological diagnosis when FNA are prepared by a manual MP processing technique.

scholarly journals Tissue acquisition for diagnosis of proximal biliary lesions using endoscopic ultrasound-guided fine-needle aspiration.

JMS SKIMS ◽  
2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Vikas Singla ◽  
Ravi Daswani ◽  
Anil Arora ◽  
Kusum Verma ◽  
Mandhir Kumar ◽  
...  
Keyword(s):  
Bile Duct ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Benign Disease ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Bile Duct Lesions ◽  
Proximal Bile Duct

Objectives: To report the diagnostic yield and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS FNA) for the evaluation of proximal bile duct lesions. Materials and methods: A retrospective analysis of data of the patients, who had undergone EUS for proximal bile duct lesions was done. FNA was performed from either the bile duct mass, enlarged node, or liver lesions. Outcome measures were the diagnostic yield of EUS FNA and adverse events. Results: From April 2011 to August 2018, 147 patients with suspected proximal bile duct malignancy underwent EUS. Mass lesion was seen in 133 (90.47%) patients. FNA was performed in 125 (85.03%) patients. The final diagnosis in patients undergoing EUS FNA was malignancy in 118, benign disease in six, and one patient was lost to follow up. EUS FNA confirmed the diagnosis in 103/118 patients with malignancy (sensitivity 87.28%); was false negative in 15/118 cases with malignancy, and was truly negative in all the six patients with benign disease (specificity 100%). Positive predictive value, negative predictive value, and the accuracy of EUS FNA were 100%, 28.57%, 87.90% respectively. No serious adverse event was reported, five patients had self-limiting pain. Conclusion: EUS FNA is a sensitive tool for the evaluation of proximal bile duct lesions. Low negative predictive value warrants further evaluation in patients with non-malignant findings on cytology.

scholarly journals A269 EUS-GUIDED ROSE FNA AND CNB FOR THE DIAGNOSIS OF PANCREATIC CANCER: A COMPARATIVE ANALYSIS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 146-147
Author(s):  
A Almudaires ◽  
G Williams ◽  
S E Gruchy ◽  
A Morgenthau
Keyword(s):  
Pancreatic Cancer ◽  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Pancreatic Tumors ◽  
Ultrasound Guided ◽  
Pancreatic Lesion ◽  
Site Evaluation

Abstract Background Endoscopic ultrasound-guided fine-needle aspiration with Rapid On Site Evaluation (ROSE EUS-FNA) and endoscopic ultrasound-guided core-needle biopsy (EUS-CNB) are widely used for the diagnosis of pancreatic tumors. There is no known published randomized control trial that compares between the two modalities. Given the aggressive nature of pancreatic cancer, it is crucial to make a prompt diagnosis in order to initiate treatment in a timely fashion. Aims This study compares the diagnostic performance of ROSE EUS-FNA and EUS-CNB for diagnosis of pancreatic cancer. Methods A retrospective review was performed for patients who underwent ROSE EUS-FNA and/ or EUS-CNB for solid pancreatic lesion. Diagnostic yield (defined as percentage of diagnostic samples), diagnostic accuracy (defined as percentage of correct diagnosis), sensitivity and specificity for malignancy were compared between ROSE EUS- FNA and EUS- CNB. Baseline characteristics for both patients and lesions were also obtained. Results A total of 82 patients with solid pancreatic lesions were reviewed. 84 EUS with 61 FNA and 74 CNB were performed. The diagnostic yield was 42/61 (69%) and 59/74 (79.7%) for FNA and CNB respectively (P 0.166). The diagnostic accuracy was 33/61 (54%) and 53/74 (71%) for FNA and CNB respectively (P 0.0326). 50 patients underwent both FNA and CNB during the same EUS. The calculated diagnostic yield among this subgroup was 33/50 (66%) and 39/50 (78%) for FNA and CNB respectively (P 0.265); with diagnostic accuracy of 26/50 (52%) for FNA and 34/50 (68%) for CNB (P 0.152). The diagnostic accuracy after combining both techniques was 40/50 (80%). The incremental increase in diagnostic yield by combining both methods was 12/50 (24%) and 6/50 (12%) relative to FNA and CNB respectively. The sensitivity for the diagnosis of malignancy for FNA and CNB was 60.8% and 92.7%, respectively. The specificity was 100% for both methods. Conclusions EUS-guided CNB is a superior method of assessing solid pancreatic lesion and pancreatic malignancy with better diagnostic yield and accuracy and higher sensitivity than ROSE EUS-FNA. Funding Agencies None

Evaluation of Cell Block Diagnostics in Intra-Abdominal Lesions with Radiological and Clinical Correlation in a Tertiary Centre in North Karnataka Region

2021 ◽  
Vol 8 (19) ◽  
pp. 1397-1402
Author(s):  
Md Hamed Altaf Mali ◽  
Anita A. M ◽  
Meenakshi Meenakshi ◽  
Anuradha G Patil
Keyword(s):  
Diagnostic Yield ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Vital Role ◽  
Cell Block ◽  
Diagnostic Modality ◽  
Fluid Analysis ◽  
Neoplastic Lesions ◽  
Malignant Lesions ◽  
Abdominal Lesions

BACKGROUND Cytological examination of intra-abdominal lesions is crucial in diagnosis, staging, and prognosis of suspected malignancies. Fine needle aspiration cytology (FNAC) is a routine diagnostic modality for diagnosis. FNAC is a reliable, rapid, cost effective procedure and plays an important role particularly in low resource centres. FNAC along with cell block has shown remarkable result in diagnosis of malignant lesions and its sub-classification using various antibody markers. METHODS A total of 102 cases of intra-abdominal lesions were studied over a period of one year in this descriptive study. Ultrasound sonography (USG) guided FNACs were done in 89 cases and ascetic / peritoneal fluid analysis in 13 cases. Cell blocks were made in 95 cases and immunohistochemistry (IHCs) were done in 69 cases of suspected / malignant intra-abdominal lesions to confirm the diagnosis. RESULTS Out of 102 cases, cytological smears in 89, fluid smears in 13 and cell blocks in 95 cases were available respectively. Most common intra-abdominal organ involved was liver (21.56 %) followed by retroperitoneum (17.65 %) and lymph nodes (14.70 %). The intra-abdominal lesions were classified into non - neoplastic (16.67 %) and neoplastic lesions (83.33 %). Neoplastic lesions (83.33 %) were further sub classified into benign (15.68 %) and malignant (67.65 %). IHC was done in all malignant lesions for confirmation of primary and / or metastasis. Complete concordance between cell blocks and smears was observed in 95 / 102 cases (93.14 %), while discordances were noted in 05 out of 102 cases (06.86 %). CONCLUSIONS Cell blocks play a vital role in cytopathology and as an adjunct to the routine cytology smears and body fluids. Cell buttons are cost effective and simple to make without involving much higher technicality. Cell block sections offer advantages with respect to cellular architecture, archival storage and application of IHCs which help in pin-pointing the diagnosis. Hence, cell blocks must be considered to increase the diagnostic yield and efficacy. KEYWORDS Cytopathology, Malignant Lesions, Immuno - Histochemistry, Diagnostic Utility

The Application of Fine Needle Aspiration Biopsy in the Diagnosis of Axillary Masses

2021 ◽  
pp. 1-7
Author(s):  
Cong-Gai Huang ◽  
Meng-Ze Li ◽  
Shao-Hua Wang ◽  
Xiao-Qin Tang ◽  
Johannes Haybaeck ◽  
...  
Keyword(s):  
Lymph Node ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Benign Lesions ◽  
Fine Needle ◽  
Significant Difference ◽  
Malignant Lesions ◽  
Axillary Mass

<b><i>Introduction:</i></b> We intend to determine the diagnostic power of fine needle aspiration biopsy (FNAB) for differentiation between malignant and benign lesions on axillary masses and draw the physicians’ attention to the benefits of FNAB cytology in the diagnosis of axillary masses. <b><i>Methods:</i></b> In this study, 1,328 patients with an axillary mass diagnosed by FNAB were retrospectively reviewed. These cases were registered at the affiliated hospital of Southwest Medical University (China), July 2014 to June 2017. Cytological results were verified either by histopathology following surgical resection or clinical follow-up. <b><i>Results:</i></b> Of the 1,328 patients affected by axillary masses, 987 (74.3%) cases were female, and 341 (25.7%) cases were male. The highest incidence of patients was in the age group of 41–50 years (375, 28.2%). There were 1,129 (85.0%) patients with benign lesions and 199 (15.0%) with malignant lesions. Of the 199 malignant lesions cases, 21 cases were lymphomas, 2 cases were accessory breast cancers, and 176 cases were lymph node metastatic tumors. Under lymph node metastases, the most frequent primary tumors were breast cancer (141, 80.1%), followed by lung cancer (21, 11.9%). According to the study, the characters of 1,328 cases showed statistically significant difference (χ<sup>2</sup> = 4.534, <i>p</i> = 0.033), and the incidence of females with axillary mass was significantly higher than that of males. There was a statistically significant difference in the distribution of benign and malignant cases in the patient age groups (χ<sup>2</sup> = 1.129, <i>p</i> = 0.000), and the incidence of patients of 41–50 years of age was significantly higher than that of other patients. The diagnostic accuracy of FNAB in axillary masses was analyzed with the results of 95.98% of sensitivity, 99.56% of specificity, 97.45% of positive predictive value, and 99.29% of negative predictive value. <b><i>Conclusion:</i></b> Our results confirm that FNAB is a valuable initial screening method regarding pathologic diagnosis of axillary mass, in particular with respect to malignancy in 41- to 50-year-old female patients.

scholarly journals Apparent diffusion coefficient for differentiating between benign and malignant hepatic focal lesions

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sherif Abugamra ◽  
Aya Yassin ◽  
Asmaa Saber Mostafa Abdel-Rehim ◽  
Dina Sayed Sheha
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Focal Lesion ◽  
Benign Lesions ◽  
Focal Lesions ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Malignant Lesions ◽  
The Mean

Abstract Background The aim of this study was to prospectively evaluate the role of diffusion weight MRI (DWI) in the characterization of hepatic focal lesions by using apparent diffusion coefficient (ADC). Thirty patients (18 women, 12 men; mean age 48.5 years) with hepatic focal lesions were included in this study. Patients underwent DW MR imaging with the SPLICE sequence. ADC of each focal lesion carcinoma was calculated from DW MR Images obtained with low and high b values. ADCs were compared among pathological types of focal lesions. Results Among the 30 patients included in the study, 46 focal lesions were detected. Twenty-four lesions were metastatic lesions from primary cancer, 7 lesions were hepatocellular carcinoma (HCC), 9 lesions were hemangiomas, and 6 lesions were simple cysts. There was highly significant difference between the mean ADC of the malignant lesions (metastasis and HCC) and the mean ADC of benign lesions (hemangiomas and cysts). The ADC of malignant lesion was much less than that of benign lesion. The mean ADC of malignant lesions (n = 31) was 0.73 ± 0.19 × 10−3 mm2/s, and the mean ADC of benign lesions (n = 15) was 1.94 ± 0.68 × 10−3 mm2/s (p value < 0.001). There was no significant difference between the cysts and hemangiomas. There was no statistically significant difference between the metastases and hepatocellular carcinoma. Conclusion ADCs values were able to differentiate benign from malignant lesions. ADC should be considered in the work up of patients with hepatic focal lesions.

Mediastinal Nodular Lymphocyte Predominant Hodgkin Lymphoma Achieved by Endoscopic Transesophageal Cryobiopsy

Respiration ◽  
2021 ◽  
pp. 1-5
Author(s):  
Zan-Sheng Huang ◽  
Dong Zhou ◽  
Jing Zhang ◽  
Wan-Lei Fu ◽  
Jing Wang ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Diagnostic Yield ◽  
Cancer Staging ◽  
Needle Aspiration ◽  
Sample Volume ◽  
Small Sample ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Initial Sampling

Guidelines have recommended endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine-needle aspiration biopsy as initial sampling approaches of mediastinal lymph nodes for lung cancer staging. However, the small sample volume might restrict the diagnostic utility of needle aspiration in certain mediastinal diseases. We have recently shown that transbronchial mediastinal cryobiopsy, which is capable of providing larger amounts of intact tissue, improves diagnostic yield in rare tumors and benign diseases compared to EBUS-TBNA. Here, we present a case of mediastinal nodular lymphocyte predominant Hodgkin lymphoma successfully diagnosed by endoscopic transesophageal cryobiopsy.

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