Diagnostic yield of biopsies of cervical lymph nodes using a large (14-gauge) core biopsy needle

The purpose of this study was to assess retrospectively complications and diagnostic yield of core needle biopsy (CNB) of cervical lymph nodes using 14-gauge as sole needle bore. During a 10-year period ultrasound (US)-guided CNB, using a 14-gauge Tru-Cut needle (non-advancing), was performed in 140 consecutive cases (135 patients, aged 8-88 years) when a detailed histological diagnosis was required to guide therapy. CNB findings were consistent with the final diagnosis in 129 of the 140 cases, comprising 36 benign lesions, 40 metastases, and 53 lymphomas (40 NHL and 13 HL) of which subclassification (WHO criteria) was partial in 5NHL, and complete in 35 (87.5%) NHL and 13 HL (100%), including all 7 lymphomatous nodes with short-axis diameter ≤1.0 cm. Two lymphomas were falsely interpreted as reactive hyperplasia. Nine samples (6.4%) were inadequate for histopathological analysis. One patient experienced pain in an arm lasting 3-4 days. No other immediate or delayed complications were diagnosed. A 14-gauge may be used safely as the sole needle bore in US-guided CNB of cervical lymph nodes, rendering samples sufficient for full subtyping in lymphoma, even in the smallest nodes.