Risk Factors for Diagnostic Failure of Ultrasound-Guided Core Needle Biopsy of Soft-Tissue Tumors Based on World Health Organization Classification Category and Biologic Potential

2020 ◽  
Vol 214 (2) ◽  
pp. 413-421
Author(s):  
Min A Yoon ◽  
Hye Won Chung ◽  
Choong Guen Chee ◽  
Min Hee Lee ◽  
Sang Hoon Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Needle Biopsy ◽  
Soft Tissue Tumors ◽  
World Health ◽  
Ultrasound Guided ◽  
World Health Organization Classification ◽  
Core Needle ◽  
Health Organization ◽  
Classification Category

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

2020 ◽  
Vol 24 (06) ◽  
pp. 667-675
Author(s):  
Violeta Vasilevska Nikodinovska ◽  
Slavcho Ivanoski ◽  
Milan Samardziski ◽  
Vesna Janevska
Keyword(s):  
Soft Tissue ◽  
Complication Rate ◽  
Core Needle Biopsy ◽  
Multidisciplinary Team ◽  
Gold Standard ◽  
Needle Biopsy ◽  
Soft Tissue Tumors ◽  
Open Biopsy ◽  
Core Needle ◽  
Similar Accuracy

AbstractBone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

scholarly journals Accuracy and Safety of Ultrasound-Guided Core Needle Biopsy of Soft Tissue Tumors in an Outpatient Setting: A Sarcoma Center Analysis of 392 Consecutive Patients

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5659
Author(s):  
Helene Weigl ◽  
Peter Hohenberger ◽  
Alexander Marx ◽  
Nikolaos Vassos ◽  
Jens Jakob ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Diagnostic Accuracy ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Outpatient Service ◽  
Outpatient Setting ◽  
Safe Procedure ◽  
Ultrasound Guided ◽  
Core Needle ◽  
Tertiary Referral Center

Background: The aim of this study was to investigate diagnostic accuracy, safety and histologic results of ultrasound guided core needle biopsy (CNB) in patients with soft tissue lesions (STL) at a tertiary referral center. Methods: A retrospective analysis of all consecutive patients undergoing ultrasound guided CNB for STL at our sarcoma outpatient service between January 2015 and August 2020 was performed. Results: A total of 392 patients were identified. Main histologic entities were sarcomas, lipomas and desmoid tumors. Biopsy was performed in an outpatient setting in 87.6% of the cases. Conclusive biopsies were obtained in 88.5% of the cases. In patients who underwent surgical resection after CNB, the concordance of dignity, tumor entity and histopathological grading between biopsy and resection specimen were 97.2%, 92.7% and 92.5% respectively. The risk of inconclusive CNB was highest in intraabdominal or retroperitoneal tumors (19.5%) and lowest in lesions at the lower extremity (4.4%). Major complications after CNB occurred in three cases (0.8%). No case of biopsy tract seeding was observed during the study period. Conclusions: Ultrasound guided CNB for STL at first presentation in a dedicated surgical outpatient setting is a safe procedure and yields a high diagnostic accuracy.

scholarly journals Diagnostic accuracy of ultrasound-guided core needle biopsy versus incisional biopsy in soft tissue sarcoma: an institutional experience

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Miroslava Cernakova ◽  
Gerhard M. Hobusch ◽  
Gabriele Amann ◽  
Philipp T. Funovics ◽  
Reinhard Windhager ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Correct Identification ◽  
Incisional Biopsy ◽  
Ultrasound Guided ◽  
Histologic Subtype ◽  
Core Needle ◽  
Biopsy Technique

AbstractCore needle biopsy (CNB) is gaining in importance due to its advantages in the matter of patient morbidity, time and cost. Nevertheless, controversies still exist regarding the biopsy technique of choice for the accurate diagnosis of soft tissue sarcoma (STS). This retrospective cohort study compared the diagnostic performance between ultrasound-guided CNB and incisional biopsy (IB), both performed by orthopedic surgeons. The aims of the study were to answer the following questions: (1) Is ultrasound-guided CNB a highly reliable modality for diagnosing STSs? (2) Is CNB equally useful to IB for identifying histologic subtype? (3) Had patients who underwent CNB a reduced risk of complications? One-hundred and fifty-three patients who underwent resection of soft tissue sarcoma were classified into two groups according to biopsy technique prior to surgery; CNB group (n = 95) and IB group (n = 58). The final surgical specimens were in 40 patients liposarcoma (myxoid, pleomorphic and dedifferentiated), 39 undifferentiated pleomorphic sarcoma (UPS), 33 myxofibrosarcoma, 10 synovial sarcoma, 10 leiomyosarcoma and in the remaining 21 patients different soft tissue sarcoma entities. Sarcoma location of 71 patients was in the thigh, 19 in the lower leg, 22 in the upper arm and shoulder area; 10 in the knee and gluteal region, 9 in the thoracic region, the residual 12 in other body areas. Malignancy was correctly diagnosed in 87% (83 of 95) for the CNB group and 93% (54/58) for the IB group. Correct identification rate of histologic subtype was 80% (76 of 95) in the CNB group and 83% (48 of 58) in the IB group. There were no significant differences in the correct diagnosis rates of malignancy and subtype between the two techniques. No complications were seen in the CNB group, whereas 2 patients in whom IB was performed developed pulmonary embolism and 1 patient surgical site infection. Ultrasound-guided CNB is highly accurate and not inferior to IB in diagnosing the dignity of lesions and histologic subtype in patients with suspected STSs.

scholarly journals Soft Tissue Tumor Immunohistochemistry Update: Illustrative Examples of Diagnostic Pearls to Avoid Pitfalls

2017 ◽  
Vol 141 (8) ◽  
pp. 1072-1091 ◽  
Author(s):  
Shi Wei ◽  
Evita Henderson-Jackson ◽  
Xiaohua Qian ◽  
Marilyn M. Bui
Keyword(s):  
Soft Tissue ◽  
English Language ◽  
Molecular Genetic ◽  
Soft Tissue Tumors ◽  
Genetic Alterations ◽  
World Health ◽  
Immunohistochemical Markers ◽  
Classification Of Tumors ◽  
Health Organization

Context.— Current 2013 World Health Organization classification of tumors of soft tissue arranges these tumors into 12 groups according to their histogenesis. Tumor behavior is classified as benign, intermediate (locally aggressive), intermediate (rarely metastasizing), and malignant. In our practice, a general approach to reaching a definitive diagnosis of soft tissue tumors is to first evaluate clinicoradiologic, histomorphologic, and cytomorphologic features of the tumor to generate some pertinent differential diagnoses. These include the potential line of histogenesis and whether the tumor is benign or malignant, and low or high grade. Although molecular/genetic testing is increasingly finding its applications in characterizing soft tissue tumors, currently immunohistochemistry still not only plays an indispensable role in defining tumor histogenesis, but also serves as a surrogate for underlining molecular/genetic alterations. Objective— To provide an overview focusing on the current concepts in the classification and diagnosis of soft tissue tumors, incorporating immunohistochemistry. This article uses examples to discuss how to use the traditional and new immunohistochemical markers for the diagnosis of soft tissue tumors. Practical diagnostic pearls, summary tables, and figures are used to show how to avoid diagnostic pitfalls. Data Sources.— Data were obtained from pertinent peer-reviewed English-language literature and the authors' first-hand experience as bone and soft tissue pathologists. Conclusions.— —The ultimate goal for a pathologist is to render a specific diagnosis that provides diagnostic, prognostic, and therapeutic information to guide patient care. Immunohistochemistry is integral to the diagnosis and management of soft tissue tumors.

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