ULTRASONOGRAPHY‐GUIDED CORE‐NEEDLE BIOPSY OF LYMPHADENOPATHIES SUSPECTED OF LYMPHOMA: ANALYSIS OF EFFICACY AND SAFETY OF 1000 BIOPTIC PROCEDURES IN A MULTICENTER ITALIAN STUDY

Abstract

Patients with clinical suspect of lymphoma require prompt and correct diagnosis through the histological examination. The aim of this study was to evaluate the reliability and safety of the front-line ultrasonography guided core needle biopsy (UG-CNB) of suspected lymphadenopathies in a large series of patients from 4 southern Italian clinical units. Inclusion criteria were: (i) lymphadenopathy power Doppler ultrasonography retrospectively assessment on recorded video clips and/or images; (ii) 16-gauge CNB with powered automatic suction and 1.6 mm needle diameter sample; (iii) availability of lymph node sections fixed in formalin and embedded in paraffin; (iv) morphological and immunohistochemical information (assessed retrospectively by haematopathologists); and (v) information of an accepted diagnostic reference standard (either the lymphadenopathy surgical resection or follow-up assessment with 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography [FDG PET]-computed tomography [CT] showing decreased FDG uptake and/or decreased size after specific antineoplastic treatment according to the histological subtype, as well as spontaneous regression for the benign conditions). We retrospectively collected the data of 1048 patients who underwent UG-CNB between 1 July 2009 and 1 January 2022 for suspected pathological lymphadenopathies. In total, out of the 1000 UG-CNBs yielding macroscopically adequate material for histological diagnosis, the 90% (n = 900) resulted in lymph-nodes positive for malignancy. Most patients were suffering from lymphomas (aggressive B-cell non-Hodgkin lymphoma [aBc-NHL], 309 cases; indolent B-cell [iBc]-NHL, 266 cases; Hodgkin lymphoma [HL], 198 cases; and nodal peripheral T-cell [NPTC]-NHL, 27 cases) and 100 cases from metastatic carcinoma; 70 patients were negative for malignancy (diagnosis of atypical lymphadenopathies mimicking lymphomas [ALML]). The remaining 3% were inconclusive at CNB: the morphologic, immunohistochemical and/or molecular investigations did not allow a final diagnosis. Keyword: imaging and early detection No conflicts of interests pertinent to the abstract.