PubMed · 10941348
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L W Rogers, S G Ries. 2000. Another variable in lymph node biopsy.. https://pubmed.ncbi.nlm.nih.gov/10941348/
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BACKGROUND: Several arguments are used for choosing either fine-needle aspiration cytology (FNAC) or core needle biopsy (CNB) in the evaluation of breast lesions. Comparison of published data on both methods is complicated by differences in study design, calculations, and operator experience. The objective of this study was to make a direct comparison of both methods. METHODS: In 286 breast lesions (cysts and microcalcifications without a soft tissue mass excluded), both ultrasound-guided FNAC and CNB were performed in the same session by the same operator. Histologic follow-up was collected, and for those lesions that were not excised the results of the most recent mammography was used. A combination of the findings of both FNAC and CNB were evaluated. RESULTS: Core needle biopsy and FNAC do equally well for sensitivity (88% vs. 92%), positive predictive value for malignancy (99% vs. 100%), and inadequate rate (7% vs. 7%). However, statistical differences are found for the specificity (CNB, 90%; FNAC, 82%). In addition, differences are found in the positive predictive value of both suspicious (CNB, 100%; FNAC, 78%) and atypia (CNB, 80%; FNAC, 18%) and for the suspicious rate (CNB, 5%; FNAC, 13%) reflecting difficulties in interpreting some FNACs. Combining the findings of both FNAC and CNB results in an increase in absolute sensitivity, a decrease in the positive predictive value of atypia compared with FNAC and CNB per se, and a decrease in the inadequate rate for cancers. CONCLUSIONS: For the lesions selected in this study, FNAC and CNB are comparable for most parameters, but CNB has a higher specificity and lower suspicious rate. Combining results of FNAC and CNB leads to an increase in absolute sensitivity without affecting specificity and a decrease in the inadequate rate for cancers.
Percutaneous needle biopsy (PNB) of the lung is a commonly performed procedure, mainly used for the investigation of solitary pulmonary nodules. Developments in imaging, particularly computed tomography (CT), have enable accurate preliminary assessment and targeting of lesions. Improvements in needle design ensure the provision of diagnostic samples for both cytologic and histologic assessment; and the development of immunocytochemistry and immunohistochemistry have allowed improved accuracy in diagnosis. A significant improvement in diagnostic accuracy for benign lesions has been associated with the use of cutting needles that provide cores for histologic diagnosis, in contrast to cytologic analysis from fine-needle aspiration. The complications of PNB are well recorded and have not changed significantly with the newer imaging techniques and needles. The preliminary assessment of solitary pulmonary nodules, and the pretest likelihood of malignancy, has improved using contrast-enhanced CT and positron emission tomography; the latter modality is increasingly having a major impact on the investigation of patients with suspected malignancy. The performance of PNB must always be determined on an individual case basis and when the result is likely to affect management. The complementary roles of PNB, bronchoscopic biopsy, and video-assisted thoracoscopic biopsy continue to evolve.
We report a 1 day old girl with a nasal mass that was diagnosed as an intranasal glioma. The tumor mass was noted to be localized laterally from, and based along, the inferior turbinate. Nasal glioma is a developmental abnormality of neurogenic origin with no malignant potential. An intranasal mass requires careful rhinological, neurological and radiological examinations. With adequate initial removal, excisional biopsy usually allows complete recovery. A frontal craniotomy approach is preferred for those patients who have nasal glioma with an intracranial connection. With no evidence of an intracranial connection, a conservative extracranial approach is recommended.