Study of the value of core biopsy for establishing tissue diagnosis compared to excisional biopsy in enlarged cervical lymph nodes

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Department of aGeneral Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

3 Department of Diagnostic & Intervention Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Background: Core tissue biopsy involves sampling tissue with a wider gauge than is used for fine-needle aspiration
cytology. Core biopsy may be used as an alternative to surgical excisional lymph node biopsy as it would provide less risk
to the patients as regards wound infection, scar, bleeding, accessory nerve injury, and the risk of complications of general
anesthesia. The aim of this work was to assess the accuracy, specificity, and sensitivity of core biopsy in establishing tissue
diagnosis of enlarged cervical lymph nodes.
Patients and Methods: This prospective study was carried out on 100 patients, 50 for core biopsy and 50 for excisional
biopsy, aged more than 18 years old, both sexes, with cervical lymphadenopathy indicated for ultrasonography (US)-
guided core biopsy.
Results: Based on our study, the diagnostic rate of core needle biopsy (CNB) is 53 cores and 10% of them need an excisional
biopsy. 95% of lymphoma patients were diagnosed by core biopsies. Every CNB patient underwent hydrodissection and
got a safe puncture distance. In cervical lymphadenopathy diagnosis, CNB had 89% sensitivity, 100% specificity, 100%
positive predictive value, and 66% negative predictive value.
Conclusion: Performing core samples of cervical lymph nodes in cases of cervical lymphadenopathy, especially USguided
core biopsy, can be beneficial in achieving a diagnosis as well as decreasing the need for excisional biopsies
performed under general anesthesia.

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