University College London Hospitals NHS Foundation Trust, London, UK.
Eur J Haematol. 2021 Feb;106(2):267-272. doi: 10.1111/ejh.13545. Epub 2020 Dec 2.
Whilst excision biopsy is traditionally preferred, advances in radiological and histological techniques warrant a re-look at core biopsy as a viable primary diagnostic method.
Over a 3-year period, all patients who underwent core biopsy to investigate lymphoma at our centre were included.
554 consecutive patients were included (40.1% prior lymphoma and 59.4% new presentations). Three or more cores were taken in 420 (75.8%) cases. Median time from request to biopsy and biopsy to histology report was 2 (0-40) days and 7 (1-24) days, respectively. 510/544 (93.8%) biopsies were diagnostic. There was no difference in whether the biopsy was diagnostic based on indication (new vs. relapsed lymphoma) (P = .445), whether biopsy was PET-directed (P = .507), for T-cell lymphoma (P = .468) or nodal vs. extra-nodal (P = .693). Thirty-eight patients (6.9%) required a second biopsy due to inadequate tissue. In a patient experience survey, only 13.9% reported any complications (1 self-limiting minor bleeding, 4 bruising) whilst 16.7% reported any discomfort beyond 12 hours.
Core biopsy performed by experienced radiologists and analysed by expert haemato-pathologists is a reliable, well-tolerated method for diagnosing lymphoma and confirming relapse. Multiple cores can be obtained under local anaesthetic yielding sufficient material in the majority of cases.
虽然传统上更倾向于切除活检,但放射学和组织学技术的进步使得核心活检作为一种可行的主要诊断方法值得重新审视。
在 3 年期间,将在我们中心接受核心活检以诊断淋巴瘤的所有患者纳入研究。
共纳入 554 例连续患者(40.1%为既往淋巴瘤,59.4%为新发病例)。420 例(75.8%)患者取 3 个或更多核心。从申请活检到活检和活检到组织学报告的中位时间分别为 2(0-40)天和 7(1-24)天。544 例活检中有 510 例(93.8%)为诊断性活检。根据指征(新发 vs. 复发淋巴瘤)(P=0.445)、活检是否为 PET 引导(P=0.507)、T 细胞淋巴瘤(P=0.468)或结内 vs. 结外(P=0.693),活检的诊断率无差异。由于组织不足,38 例(6.9%)患者需要进行第二次活检。在患者体验调查中,仅 13.9%报告有任何并发症(1 例自行缓解的轻微出血,4 例瘀伤),而 16.7%报告有任何不适超过 12 小时。
由经验丰富的放射科医生进行核心活检,并由专家血液病理学家进行分析,是一种可靠、耐受性良好的诊断淋巴瘤和确认复发的方法。在大多数情况下,可在局部麻醉下获得多个核心,以获得足够的材料。