Percutaneous Needle Biopsy In Diagnosis Research Articles

Solitary pulmonary nodules caused by Mycobacterium avium complex.

The prevalence of Mycobacterium avium complex (MAC) pulmonary disease (PD) is increasing significantly in Japan. Among the patterns of MAC-PD, a solitary pulmonary nodule (SPN) is less common and often resembles lung cancer. The aim of this study was to identify the clinical features of MAC-SPN. SPNs culture-positive for MAC (definite cases) and culture-negative SPNs showing nucleic acid amplification test (NAAT)-positive status (probable cases) that presented between January 2007 and December 2017 were enrolled. The patients' clinical, laboratory, radiological, and microbiological findings and outcomes were investigated. This study included 28 patients (median age, 66 years; 16 men, 12 women). All patients were asymptomatic when the disease was detected. Median SPN size was 23.5mm. Twenty-six patients underwent video-assisted thoracoscopic surgery, while the others underwent percutaneous needle biopsy for diagnosis. Granulomatous inflammation was confirmed in all cases. Microbiologically, the 28 cases were divided into 17 in the definite group and 11 in the probable group. In both groups, M. avium was predominant. There were no significant differences in clinical and radiological findings and follow-up periods between the 2 groups. After diagnosis, 6 patients received medical treatment, while the others did not. The median follow-up period was 42 months, and no recurrence was observed in both groups. MAC should be considered in the differential diagnosis of SPNs in asymptomatic patients. To overcome the difficulties in diagnosing MAC-SPN, this study underscores the importance of diagnostic interventions and identification of MAC by culture and/or NAAT in biopsied specimens.

CT and CT-guided Percutaneous Needle Biopsy in Diagnosis of Primary Pulmonary Cryptococcosis in Immunocompetent Patients

CT and CT-guided Percutaneous Needle Biopsy in Diagnosis of Primary Pulmonary Cryptococcosis in Immunocompetent Patients

Utilization of Percutaneous Needle Biopsy for Breast Diagnosis in a Comprehensive Breast Center: Implications for Development of Quality Indicators.

Percutaneous needle biopsy (PNB) is the standard of care for diagnosis of breast lesions. Rates of excisional biopsy for breast diagnosis in North America have been reported at approximately 35%, although significant regional variation exists. A target rate of PNB for diagnosis of breast abnormalities is needed to facilitate quality improvement. We sought to describe the use of PNB in a referral practice, the clinical scenarios prompting PNB or surgical biopsy (SB), and the accuracy and rate of PNB to inform the ultimate development of a benchmark rate of PNB in breast diagnosis. Female patients age 18-90years, referred to Sunnybrook Health Sciences Centre, a large teaching hospital affiliated with the University of Toronto, with a breast lesion prompting tissue diagnosis with SB and/or PNB between 2002 and 2009 were studied. Each biopsied lesion was characterized by method of biopsy: PNB, SB, or PNB followed by SB. For each lesion, we collected data on patient demographics and breast cancer risk, reason for referral, imaging characteristics (breast imaging-reporting and data system classification, full description, final impression before biopsy), and pathology from each biopsy method. We report concordance between the final impression pre-biopsy and the PNB diagnosis with final surgical diagnosis where applicable. One thousand and twenty-six lesions were biopsied, 987 (96%) with PNB. The benign:malignant ratio for the entire cohort was 1.2:1. Final impression was concordant with final pathology in 674/862 (78%) and PNB diagnosis was concordant with SB pathology in 487/556 (88%). The reasons for SB without PNB were required pathologic evaluation of the entire lesion (n=19), patient choice (n=5), other biopsy technique used (n=6), technical (n=4), planned mastectomy (n=3), and enlarging mass (n=2). 155/559 (28%) of lesions without evidence of malignancy on PNB ultimately underwent SB. Papillary lesions and radial scars were more likely to undergo SB with or without prior PNB. Lesions deemed to be suspicious or malignant on final impression were more likely to be excised after a benign diagnosis at PNB. The vast majority of lesions requiring tissue diagnosis can be accurately diagnosed with PNB. Benchmarks for rates of PNB of 90% or greater may be considered for performance measurement in appropriate populations.

Percutaneous needle biopsy in diagnosis and identification of causative organisms in cases of suspected vertebral osteomyelitis

Biopsy with demonstration of the infectious organism is the gold standard for diagnosing spondylodiscitis. The purpose of this study is to evaluate the positive culture rate of image-guided percutaneous biopsy in cases of radiologically suspected and unsuspected spinal osteomyelitis and to assess the role of pathology in diagnosis. With IRB approval and in compliance with HIPAA regulations, the charts of patients undergoing 323 consecutive image-guided percutaneous spinal biopsies performed by one musculoskeletal radiology department between January 2001 and March 2007 were reviewed. Image guidance was via fluoroscopy or computed tomography. Radiological and clinical suspicion, cultures, and pathology were assessed and compared to previously published reports. In 92 cases radiographically and clinically consistent with infection (high probability of infection), 28 specimens yielded positive cultures (30.4%). Positive cultures resulted from 5 of 31 cases (16.1%) radiographically indeterminate for infection (intermediate probability of infection versus tumor). When radiographically not suggestive of infection (low probability of infection, i.e. suspicious for tumor), 10 of 200 cultures were positive (5.0%). From 113 cases sent to pathology with an intermediate or high suspicion for infection, 63 were histopathologically diagnosed as such (55.8%). Cultures were positive in 19 of those 63 cases (30.2%). Culture and/or pathology was positive in 73 (64.6%) of the 113 cases. There were no significant differences in rates of positive culture or pathology by vertebral region (p=0.51, p=0.81). The most frequently identified organisms were Staphylococcus aureus (13) and coagulase negative staphylococci (13). Our results suggest that the positive culture rate of percutaneous spinal biopsy specimens is 30.4% with radiographically high probability for infection, which is lower than previously published. Infection may also be present in cases with imaging characteristics atypical for infection (5.0%). Careful consideration must be given to the interpretation of negative culture results. This retrospective review of 323 consecutive percutaneous spine biopsies is level III evidence.

The Optimal Number of Pleural Biopsy Specimens for a Diagnosis of Tuberculous Pleurisy

To determine the optimal number of pleural biopsy (PLBX) specimens for a diagnosis of tuberculous pleurisy. Retrospective review. County hospital. We reviewed all percutaneous needle biopsy specimens of the parietal pleura in 30 patients who had tuberculous pleurisy. Data are reported as mean+/-SEM and statistical comparisons are done with the Mann-Whitney test. We accepted p<0.05 as statistically significant. The number of biopsy specimens obtained from each patient ranged from 4 to 10 with 1 sample submitted for mycobacterial culture and the rest submitted for histologic study. Sixty percent of patients had pleural cultures positive for Mycobacterium tuberculosis and 80% had diagnostic histology. Overall pleural biopsy sensitivity (histology and culture) for tuberculous pleurisy was 87%. On average, 40.4%+/-4.7% of all PLBX specimens contained pleura. Diagnostic PLBX procedures compared to false-negative procedures produced more tissue specimens (7.1+/-0.3 vs 4.8+/-0.5, p=0.005) containing more pleural specimens (2.4+/-0.2 vs 0.8+/-0.5, p=0.01). If only PLBX procedures yielding more than six tissue specimens (n=18) or more than two pleural specimens (n=12) were analyzed, then the diagnostic sensitivity of PLBX for pleural tuberculosis was 100%. There seemed to be a direct relationship between the sensitivity of PLBX and the number of specimens submitted. The sensitivity of percutaneous needle biopsy for diagnosis of tuberculous pleurisy is highest when more than six specimens are obtained which, on average, contain more than two specimens of parietal pleura. There are no conclusive data indicating how many tissue specimens to submit for mycobacterial culture, but one specimen seems sufficient.

Percutaneous needle biopsy for diagnosis of pancreatic cancer.

Percutaneous fine needle aspiration biopsy of the pancreas is a safe procedure, which may be done inexpensively and rapidly accomplished with high diagnostic accuracy. The major drawback of this technique is the need for a competent cytopathologist for specimen interpretation. It is quite possible, as more trained personnel become available, that percutaneous fine needle aspiration biopsy may become the technique of choice for establishing the diagnosis of pancreatic malignancy.

胸部疾患における経皮穿刺診断

胸部疾患における経皮穿刺診断