IMAGE-GUIDED CORE-NEEDLE BIOPSY IN MALIGNANT-LYMPHOMA - EXPERIENCE WITH 100 PATIENTS THAT SUGGESTS THE TECHNIQUE IS RELIABLE

Purpose: In an initial evaluation of 1,500 computed tomography (CT)-gu ided core-needle biopsies performed at our institute during the period from 1989 to 1994, we encountered 100 patients with the diagnosis of lymphoma. Here, we review the clinical impact of 109 image-guided need le biopsies in these 100 patients with non-Hodgkin's lymphoma (NHL) an d Hodgkin's disease (HD). Patients and Methods: NHL was diagnosed in 7 1 patients,and 29 had HD. Among the NHL patients, 17(24%) held proven lymphoma diagnosed before the biopsy was performed; in 54 (76%) core-n eedle biopsy was performed as the first diagnostic procedure. Of 29 HD patients, nine (31%) were already established cases of HD, and in 20 (69%) core-needle biopsy was the first diagnostic procedure attempted. Most of the biopsies were performed under CT control using a 20- or 1 8-gauge Turner biopsy needle. Results: Eighty-six patients received th erapy based on the results of the needle biopsy alone. Fourteen patien ts received therapy after undergoing surgical biopsy for a suspected d iagnosis of lymphoma, which could not be established with certainly, o n the basis of an earlier core-needle biopsy alone. In 78% of the pati ents, the needle biopsy saved a further surgical procedure that may ha ve been difficult to perform because of the primary location of the tu mor. Conclusion: From our experience in this study, image-guided core- needle biopsies provide sufficient information for the diagnosis of an d subsequent therapeutic decision to treat most cases of lymphoma. (C) 1996 by American Society of Clinical Oncology.