Ultrasound-guided fine needle biopsy of the spleen: High clinical efficacyand low risk in a multicenter Italian study

The aim of this study was to evaluate the clinical efficacy and safety of t he ultrasound-guided fine needle biopsy (UG-FNB) of the spleen in a large p opulation of patients. We collected retrospectively the findings concerning the application of UG-FNB of the spleen from eight Italian clinical center s that utilized this technique for at least ten years. A data schedule was sent to all centers to collect information about techniques, results, and c omplications of UG-FNB of the spleen. We analyzed 398 biopsy procedures bot h on focal lesions (257 cases) and on splenic parenchyma (141 cases). The o verall accuracy was 90.9% for the series as a whole, 84.9% for cytological sampling, 88.3% for microhistological sampling, and 90.3% for both cytologi cal and histological sampling (double biopsy). Tissue core biopsy yielded b etter overall accuracy in patients with suspected splenic involvement by ly mphoma (90.9% vs. 68.5% for cytology), The complication rate was low (no de ath cases, less than 1% for major complications, and 5.2% for all complicat ions). No predictive factors were able to detect high-risk situations. The operator's skill (higher number of performed procedures) was significantly related to better overall accuracy. Conversely, the complication rate was n ot affected. UG-FNB of the spleen is a very effective diagnostic procedure with low risk for the patient. Aspiration cytology and core needle biopsy s howed similar diagnostic yields, except for the diagnosis of splenic lympho ma, in which core needle biopsy obtained better results. Am. J. Hematol. 67 :93-99, 2001, (C) 2001 Wiley-Liss, Inc.