Ultrasound-guided 1.2-mm cutting-needle biopsies of head and neck tumours

To establish the role of ultrasound-guided cutting-needle biopsy in the diagnostic-work-up of tumours in the head and neck region.

Seventy-two patients (74 biopsies) with tumours in the head and neck were biopsied by means of a biopsy gun fitted with a 1.2-mm biopsy needle (midsized-needle biopsy, MNB). Twenty-four biopsies were taken from salivary glands, 29 from lymph nodes, and 21 from miscellaneous locations. Thirty-three of the patients were biopsied by MNB under ultrasound guidance after a blinded fine-needle aspiration biopsy (FNAB) was considered non-diagnostic or non-representative.

In 91% of the cases, the MNB diagnosis was identical to the final diagnosis (surgical or radiological/clinical follow-up: at least 6 months), 9% were false-negative/ non-representative. In 17/33 patients MNB was considered to provide more diagnostic information than FNAB, the methods had equal accuracy in 12 patients, and in 4 patients the information already gained with FNAB was superior to that provided by MNB. The non-diagnostic sampling rate for FNAB was 25% versus 3% for MNB. In 26 patients with malignant lymphoma, MNB results were diagnostically correct in all but 2 cases. FNAB was correct in 2 of 9 cases. There were no biopsy-related complications.

MNB was found to be safe and to possess a high degree of diagnostic accuracy, and could therefore, particularly in patients with lymphoma, be considered a diagnostic alternative to FNAB.