ROLE OF IMAGE-GUIDED CORE-NEEDLE BIOPSY IN THE MANAGEMENT OF PATIENTSWITH LYMPHOMA

Purpose: The results of 106 radiologically guided core-needle biopsies in 96 patients were analyzed retrospectively to evaluate the accuracy , safety, and role of this technique in the management of patients wit h lymphoma and to determine factors predictive of success. Patients an d Methods: Biopsies were performed in 51 patients with low-grade non-H odgkin's lymphoma (NHL), 24 with high-grade NHL, 16 with previously di agnosed Hodgkin's disease (HD), and 15 with no previous history of lym phoma. Disease was infradiaphragmatic in 92 patients and supradiaphrag matic in 14, Computed tomography (CT) guidance was used in 98 biopsies and ultrasonography (US) in eight. Results: The biopsy was diagnostic and yielded information on the basis of which treatment was started i n 88 of 106 patients, The procedure was well tolerated and there were no major complications, Small size of the sample or inappropriate tiss ue sampled were the main causes of failure, The technique was equally successful in the diagnosis of HD and both high-grade and low-grade NH L as in nonlymphoproliferative disorders. The procedure was equally su ccessful at diagnosis as at suspected recurrence or progression. In 33 of 80 cases in which the biopsy was performed at the time of recurren ce or progression, the histology had changed; in 31 of 33, this influe nced treatment. The technique was efficient at diagnosing transformati on of follicular NHL in 16 of 18 patients, which allowed early adjustm ent of treatment at recurrence. Conclusion: At St Bartholomew's hospit al (SBH), image-guided core-needle biopsy has proven to be a quick, sa fe, and efficient alternative to excisional biopsy in the evaluation o f lymphoproliferative disorders at presentation, recurrence, or progre ssion. It should become the procedure of choice for histologic samplin g in the absence of peripheral lymphadenopathy. (C) 1996 by American S ociety of Clinical Oncology.