Abstract
Core needle: From the other 335, 116 were benign tumours or tumour-like conditions, 86 primary malignant, 53 lesions oh Hematopoietic, lymphoid and biopsy is simple, practical and easily permits diagnosis of bone and soft tissue tumours and tumour-like conditions even when immunohistochemical studies are needed.
We present the results of 412 core needle biopsies guided with fluoroscopy, CT and echo scan with assessment of accuracy and costs
From January/96 to December/08, 56 soft tissue and 356 bone tumours and tumour-like lesions were submitted to this technique in the Oncology Unit of Hospital Santo Antònio. All biopsies were performed by the same team (one radiologist, one orthopaedic surgeon) and the histological exam by the same pathologist.
There were 77 cases in which diagnosis was inconclusive (sample not representative, crushing, necrosis, hemorrhagic features or image/histological dissociation); 36 of these were soft tissue and 41 bone lesions. histiocytic elements, 65 metastases, 8 recurrent malignancies, 5 osteomyelitis and 2 metabolic diseases.
Diagnosis was confirmed in 278 cases with the definitive surgery and only one was wrong. The other 57 cases were later controlled by imaging exams and there were no reasons to suspect a wrong diagnosis.
No complications occurred.
Costs were estimated to be less than one fifth of an open biopsy.
The high accuracy (only one case was misdiagnosis), the safety, the costs and the fact that in only 18,7% the diagnosis was not established make us consider this method effective and to be encouraged. Better selection of lesions and more attention to directions of the cores may low the number of inconclusive diagnosis.
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
