Computed tomography (CT) and ultrasound (US) guided core biopsy in the management of non-Hodgkin's lymphoma.

Histological examination of adequate biopsy specimens is fundamental to the management of patients with non-Hodgkin's lymphoma (NHL). A practical alternative to open biopsy, provided enough tissue can be obtained, has obvious advantages, especially if the lesion in question is deep seated, and might call for laparotomy or thoracotomy. Core biopsy with computed tomography (CT) or ultrasound (US) guidance may be such an alternative, particularly when a spring-loaded firing device is used. Thirty-four biopsies were performed in 26 patients with known or suspected NHL. A primary histological diagnosis was made in 7/7 (six NHL, one seminoma). Relapse was confirmed in 15/15 patients overall. In patients with follicular NHL, 8/15 biopsies showed progression to high grade histology. Biopsies were also performed to assess the nature of residual abnormalities after treatment and to obtain fresh tissue for immunocytochemistry. Tissue was obtained in all cases and a further procedure (two laparotomies, one second needle biopsy) was required on only three occasions. The procedure was well tolerated and there were no complications. This technique is therefore a valuable alternative to more invasive surgical procedures and may be of major benefit in the management of NHL.