The use of ultrasound-guided cutting-needle biopsy in the neck

Histological analysis of an abnormal neck mass has traditionally required an excision biopsy under general anaesthetic. We evaluated the safety and accuracy of a new spring loaded cutting-needle for obtaining tissues cores of neck masses under ultrasound (US) guidance. Sixty biopsies were performed on an outpatient basis under local anaesthesia in 52 patients referred with a neck mass. Patients ranged in age from 10 months to 89 years and masses varied in size from 5 mm to 5 cm. Fifty-eight of the 60 biopsies provided a diagnostic histological specimen. Of the remaining two patients, one required open biopsy and the other returned for a second needle biopsy. All five cases of lymphoma were correctly diagnosed on needle biopsy; in three cases full tumour sub-classification was possible but in two patients an open biopsy was subsequently required. In 49 patients the needle biopsy obviated the need for a surgical biopsy for diagnostic purposes, although in 12 cases a therapeutic excision biopsy was performed. Apart from one subclinical haematoma, visualized on US, there were no immediate or delayed complications. In all patients, the histological diagnosis was compatible with subsequent clinical, radiological, surgical or autopsy findings. Cutting-needle biopsy of neck masses under US guidance is an effective and safe procedure which should be considered before resorting to routine surgery.