SMALL LYMPH-NODES OF THE ABDOMEN, PELVIS, AND RETROPERITONEUM - USEFULNESS OF SONOGRAPHICALLY GUIDED BIOPSY

PURPOSE: To evaluate the usefulness of sonographically guided percutan eous biopsy of small lymph nodes in the abdomen, retroperitoneum, and pelvis. MATERIALS AND METHODS: From May 1995 through January 1997, 35 sonographically guided lymph node biopsies were performed in 34 patien ts. All biopsies were performed with a 20- (n = 18) or 22-gauge (n = 1 0) self-aspirating needle alone or in combination (n = 7). To determin e the amount of compression achieved with the transducer, the skin-to- lesion distance on reference computed tomographic (CT) scans was compa red with that on sonograms. A biopsy was considered successful if a sp ecific benign or malignant diagnosis was rendered by the pathologist. RESULTS: Of 35 sonographically guided biopsies, 30 (86%) were successf ul. Diagnoses included 26 (74%) cases of carcinoma, three (9%) cases o f benign reactive lymphocytosis confirmed at open biopsy, and one (3%) case of a lymph node with a positive acid-fast bacilli stain. The ave rage lymph node diameter was 2.1 cm (range, 0.9-4.3 cm). With sonograp hy, a mean of 2.5 needle passes (range, 1-5) were made per biopsy. Tra nsducer compression reduced the skin-to-lesion distance from an averag e of 8.8 cm (at CT) to 4.5 cm. CONCLUSION: Sonographic guidance seems to provide a reasonable alternative to CT in biopsy of small abdominal , pelvic, and retroperitoneal lymph nodes.