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首页> 美国卫生研究院文献>Cancer Medicine >Use of percutaneous image-guided coaxial core-needle biopsy for diagnosis of intraabdominal lymphoma
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Use of percutaneous image-guided coaxial core-needle biopsy for diagnosis of intraabdominal lymphoma

机译：经皮影像引导下同轴心针活检在腹腔内淋巴瘤诊断中的应用

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Although pathological diagnosis is essential for managing malignant lymphoma, intraabdominal lesions are generally difficult to approach due to the invasiveness of abdominal surgery. Here, we report the use of percutaneous image-guided coaxial core-needle biopsy (CNB) to obtain intraabdominal specimens for diagnosing intraabdominal lymphomas, which typically requires histopathological and immunohistochemical evaluation. We retrospectively reviewed consecutive cases involving computed tomography (CT)- or ultrasonography (US)-guided CNB to obtain pathological specimens for intraabdominal lesions from 1999 to 2011. Liver, spleen, kidney, and inguinal node biopsies were excluded. We compared CNBs with laparotomic biopsies. A total of 66 CNBs were performed for 59 patients (32 males, 27 females; median age, 63.5), including second or third repeat procedures. Overall diagnostic rate was 88.5%. None of the patients required additional surgical biopsies. Notably, the median interval between recognition of an intraabdominal mass and biopsy was only 1 day. Forty-five procedures were performed for hematological malignancies. Adequate specimens were obtained for histopathological diagnosis in 86% of cases. Flow cytometry detected lymphoma cells in 79.5% of cases. Twelve patients (nine males, three females; median age, 60) were eligible for surgical biopsy. While every postoperative course was satisfactory, median duration from lesion recognition to therapy initiation for lymphoma cases was significantly shorter for CNB than for surgical biopsy (14 vs. 35 days). While one-fourth of the patients were not eligible for the procedures, CNB is safe and highly effective for diagnosis of intraabdominal lymphomas. This method significantly improves sampling and potentially helps attain immunohistological distinction, allowing for more timely therapy initiation.
机译：尽管病理学诊断对于管理恶性淋巴瘤至关重要，但是由于腹部手术的侵入性，通常难以接近腹腔内病变。在这里，我们报告了使用经皮图像引导的同轴芯针活检（CNB）获得用于诊断腹腔内淋巴瘤的腹腔标本，这通常需要组织病理学和免疫组织化学评估。我们回顾性回顾了1999年至2011年连续涉及计算机断层扫描（CT）或超声检查（CN）引导的CNB的病例，以获取腹部内病变的病理标本。不包括肝，脾，肾和腹股沟淋巴结活检。我们将CNB与剖腹活检进行了比较。共对59例患者进行了66次CNB检查（男32例，女27例；中位年龄63.5岁），包括第二次或第三次重复手术。总体诊断率为88.5％。没有患者需要额外的手术活检。值得注意的是，腹腔内肿块识别与活检之间的中位间隔仅为1天。对血液恶性肿瘤进行了四十五次检查。在86％的病例中获得了足够的标本用于组织病理学诊断。流式细胞术检测出79.5％的淋巴瘤细胞。十二名患者（男9例，女3例；中位年龄60岁）有资格进行手术活检。尽管每个术后过程都令人满意，但对于CNB而言，从病变识别到开始治疗淋巴瘤病例的中位持续时间明显短于手术活检（14天比35天）。尽管四分之一的患者不符合该程序的要求，但CNB对腹腔内淋巴瘤的诊断是安全且高效的。此方法可显着改善采样效果，并可能有助于获得免疫组织学区别，从而可以更及时地开始治疗。

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