Ultrasound-guided biopsy of abdominal and pelvic lesions in children. A comparison between fine-needle aspiration and 1.2 mm-needle core biopsy

Background. Tissue diagnosis is mandatory prior to treatment of an abdomina l or pelvic lesion in a child. Objectives. To compare the diagnostic yield and complications of fine-needl e aspiration biopsy (FNAB) and 1.2-mm needle core biopsy (NCB) for abdomina l and pelvic lesions in children using US guidance. Material and methods. Ninety consecutive abdominal or pelvic US-guided biop sies in 61 children; 53 FNAB procedures in 43 children and 37 NCB procedure s in 34 children were retrospectively analysed. Fifty-seven biopsies were p erformed on malignant lesions and 33 on benign lesions. In 15 children, bot h FNAB and NCB were performed at the same occasion. Results. FNAB was diagnostic in 41 (77%) of 53 biopsies while NCB provided a correct diagnosis in 35 (95%) of 37 biopsies. Results were similar in bot h malignant and benign conditions. Clinically important bleeding complicate d three biopsies (3.3%); in two after FNAB and in one after combined FNAB a nd NCB. Conclusion. If FNAB were to be replaced with 1.2-mm NCB using an automatic gun, the diagnostic yield for abdominal and pelvic focal lesions in childre n would improve significantly (P < 0.05) while the complication rate would remain low. NCB may reduce the need for diagnostic and staging surgery and repeated procedures.