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Automatic core needle biopsy: a diagnostic option for head and neck masses
Gurston G Nyquist1, William David Tom, Stanley Mui
1Department of Head and Neck Surgery, Kaiser Permanente Medical Center, San Francisco, CA 94118, USA.
Archives of Otolaryngology--Head & Neck Surgery
|February 20, 2008
Summary
Core needle biopsy is a safe and effective tool for diagnosing head and neck masses, especially when lymphoma is suspected. This procedure offers a high diagnostic yield, avoiding unnecessary excisional biopsies for many patients.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Diagnostic Pathology
Background:
- Fine-needle aspiration biopsy (FNAB) is a common initial diagnostic tool for head and neck masses.
- Some lesions remain undiagnosed or require further characterization after FNAB, necessitating alternative diagnostic methods.
Purpose of the Study:
- To evaluate the diagnostic utility and safety of core needle biopsy (CNB) for head and neck masses.
- To determine the role of CNB as a diagnostic tool before resorting to excisional biopsy.
Main Methods:
- A prospective observational study was conducted in an otolaryngology-head and neck surgery outpatient clinic.
- Core needle biopsy was performed on 40 consecutive patients with cervicofacial lesions larger than 1.5 cm, previously undiagnosed by FNAB.
- Manually guided Delta Cut core needle biopsy was utilized.
Main Results:
- A sufficient specimen for diagnosis was obtained in 90% (36/40) of patients via core needle biopsy.
- The diagnosis was confirmed in 86% (19/22) of patients who underwent subsequent excisional biopsy or surgery.
- Core needle biopsy successfully diagnosed lymphoma in 86% (12/14) of relevant cases with no reported complications.
Conclusions:
- Core needle biopsy is a safe, effective, and time-efficient procedure for diagnosing head and neck masses.
- It is particularly valuable for lesions requiring immunohistochemical staining or those undiagnosed by FNAB.
- CNB should be considered as a diagnostic step prior to excisional biopsy, especially when lymphoma is suspected.
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