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Complications of MRI-guided stereotactic biopsy of brain lymphoma
Hana Malikova1, Roman Liscak2, Iva Latnerova1
1Department of Radiology, Na Homolce Hospital, Prague, Czech Republic.
Objectives:
Stereotactic biopsy is a suitable method for sampling intrinsic brain lesions. Although this method is considered to be a safe procedure, some risk of complications still exists. The aim of the study was to retrospectively assess the morbidity and mortality of MRI-guided stereotactic biopsy of lesions which were histologically proven to be brain lymphoma.
Methods:
We retrospectively studied all accessible medical records for patients who had undergone MRI-guided stereotactic biopsy of brain lesions with histologically proven brain lymphoma from January 2007 to December 2012. Our cohort included 45 patients, 27 males and 18 females, aged 23-84 (63±14) years.
Results:
Forty-nine biopsies were carried out on 45 patients; the average number of tissue specimens was 3±1. The diagnostic yield of the stereotactic biopsy was 92%. Overall major morbidity directly related to stereotactic biopsy of brain lymphoma was 6.1% (3 cases) including 4.1% mortality (2 cases). Both deaths after the stereotactic procedure were due to intracranial hemorrhage and subsequent complications and both these patients had a history of treatment of systemic lymphomas. In one patient the stereotactic biopsy was complicated by a brain abscess which was successfully treated.
Conclusion:
Stereotactic biopsy is still a mandatory diagnostic procedure for primary brain lymphomas, with an acceptable risk of complications. However, according to our results, the risk of complications can be higher in patients who have previously been treated for secondary lymphomas.
Insights
MRI-guided stereotactic biopsy is a safe and essential diagnostic tool for brain lymphoma, with a 92% diagnostic yield. However, patients with a history of lymphoma treatment face a higher risk of complications, including mortality from hemorrhage.
Area of Science:
- Neurology
- Neurosurgery
- Oncology
Background:
- Stereotactic biopsy is a standard procedure for diagnosing intrinsic brain lesions.
- While generally safe, stereotactic biopsy carries inherent risks of complications.
Purpose of the Study:
- To evaluate the morbidity and mortality associated with MRI-guided stereotactic biopsy.
- To assess the safety and efficacy of this procedure specifically for brain lymphoma diagnosis.
Main Methods:
- Retrospective analysis of medical records from January 2007 to December 2012.
- Inclusion of 45 patients (27 males, 18 females) diagnosed with brain lymphoma via stereotactic biopsy.
- Average of 3 tissue specimens collected per biopsy.
Main Results:
- A diagnostic yield of 92% was achieved.
- Overall major morbidity was 6.1% (3 cases), with a 4.1% mortality rate (2 cases).
- Deaths were attributed to intracranial hemorrhage; complications were higher in previously treated lymphoma patients.
Conclusions:
- Stereotactic biopsy remains a crucial diagnostic method for primary brain lymphomas.
- The procedure offers an acceptable risk profile for initial diagnosis.
- Previously treated patients with secondary brain lymphomas may experience increased complication risks.
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