Michael Mueller, Genia Wittich, Suemeyra Oeztuerk, Wolfgang Kratzer^*, Mark Martin Haenle, Richard Andrew Mason

Show more
Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
Department of Veterans Affairs, Louis Stokes Cleveland Medical Center, Brecksville, USA.
Show less

Abstract: Purpose: The study investigated the rate of complications associated with sonographically guided lymph node biopsies and assessed potential risk factors. Methods: A total of 536 sonographically guided puncture procedures (283 males, 52.8%; 253 females, 47.2%; average age 57.0 ± 16.0 years; range 14 - 87 years) were performed in 469 patients for the work-up of unclear lymphadenopathy. Events, complications and potential risk factors, were prospectively documented. Results: The 469 patients underwent a total of 536 puncture procedures (PP) including 663 punctures and 1485 passes. Lymph node localizations were intraabdominal (55.2%, n = 296), cervical (22.4%, n = 120), inguinal (12.9%, n = 69), axillary (7.8%, n = 42) and other (1.7%, n = 9). No complications were documented during the entire study period. There was no increased risk of complications documented for the potential risk factors number of punctures, the number of passes, the localization, diameter of the lymph node (s), puncture technique, needle gauge, as well as patients’ sex, age and coagulation parameters, and the experience of the examiner. Conclusions: Our findings confirm the safety of percutaneous sonographically guided lymph node biopsies in different regions of the body in patients with adequate coagulation parameters undergoing pre-interventional color Doppler ultrasound examination.

Keywords: Lymph Nodes; Complications; Biopsy; Ultrasonography

Cite this paper: Mueller, M. , Wittich, G. , Oeztuerk, S. , Kratzer, W. , Haenle, M. and Mason, R. (2012) Sonographically guided lymph node biopsy: Complication rates. Open Journal of Clinical Diagnostics, 2, 30-35. doi: 10.4236/ojcd.2012.22006.

References

[1]   Screaton, N.J., Berman, L.H. and Grant, J.W. (2002) Head and neck lymphadenopathy: Evaluation with USguided cutting-needle biopsy. Radiology, 224, 75-81. doi:10.1148/radiol.2241010602

[2]   Kim, B.M., Kim, E.K., Kim MJ, et al. (2007) Sonographically guided core needle biopsy of cervical lymphadenopathy in patients without known malignancy. Journal of Ultrasound in Medicine, 26, 585-591.

[3]   Takashima, S., Sone, S., Nomura, N., et al. (1997) Nonpalpable lymph nodes of the neck: Assessment with US and US-guided fine-needle aspiration biopsy. Journal of Clinical Ultrasound, 25, 283-292. doi:10.1002/(SICI)1097-0096(199707)25:6<283::AID-JCU1>3.0.CO;2-8

[4]   Cheung, Y.C., Wan, Y.L., Lui, K.W. and Lee, K.F. (2000) Sonographically guided core-needle biopsy in the diagnosis of superficial lymphadenopathy. Journal of Clinical Ultrasound, 28, 283-289. doi:10.1002/1097-0096(200007/08)28:6<283::AID-JCU3>3.0.CO;2-T

[5]   Nagano, T., Nakai, Y., Taniguchi, F., et al. (1991) Diagnosis of paraaortic and pelvic lymph node metastasis of gynecologic malignant tumors by ultrasound-guided percutaneous fine-needle aspiration biopsy. Cancer, 68, 2571-2574. doi:10.1002/1097-0142(19911215)68:12<2571::AID-CNCR2820681207>3.0.CO;2-9

[6]   Fisher, A.J., Paulson, E.K., Sheafor, D.H., Simmons, C.M. and Nelson, R.C. (1997) Small lymph nodes of the abdomen, pelvis, and retroperitoneum: usefulness of sonographically guided biopsy. Radiology, 205, 185-190.

[7]   Abe, H., Schmidt, R.A., Sennett, C.A., Shimauchi, A. and Newstead, G.M. (2007) US-guided core needle biopsy of axillary lymph nodes in patients with breast cancer: Why and how to do it. RadioGraphics, 27, S91-S99. doi:10.1148/rg.27si075502

[8]   al-Mofleh, I.A. (1992) Ultrasound-guided fine needle aspiration of retroperitoneal, abdominal and pelvic lymph nodes. Diagnostic reliability. Acta Cytology, 36, 413-415.

[9]   Memel, D.S., Dodd, G.D., 3rd and Esola, C.C. (1996) Efficacy of sonography as a guidance technique for biopsy of abdominal, pelvic, and retroperitoneal lymph nodes. American Journal of Roentgenology, 167, 957962.

[10]   Veerapand, P., Chotimanvijit, R., Laohasrisakul, N. and Muennooch, W. (2004) Percutaneous ultrasound-guided fine needle aspiration of abdominal lymphadenopathy in AIDS patients. Journal of the Medical Association of Thailand, 87, 400-404.

[11]   Kline, T.S., Kannan, V. and Kline, I.K. (1984) Lymphadenopathy and aspiration biopsy cytology. Review of 376 superficial nodes. Cancer, 54, 1076-1081. doi:10.1002/1097-0142(19840915)54:6<1076::AID-CNCR2820540624>3.0.CO;2-W

[12]   Lioe, T.F., Elliott, H., Allen, D.C. and Spence, R.A. (1999) The role of fine needle aspiration cytology (FNAC) in the investigation of superficial lymphadenopathy; uses and limitations of the technique. Cytopathology, 10, 291297.doi:10.1046/j.1365-2303.1999.00183.x

[13]   Oyen, R.H., Van Poppel, H.P., Ameye, F.E., et al. (1994) Lymph node staging of localized prostatic carcinoma with CT and CT-guided fine-needle aspiration biopsy: Prospective study of 285 patients. Radiology, 190, 315322.

[14]   Sheafor, D.H., Paulson, E.K., Simmons, C.M., DeLong, D.M. and Nelson, R.C. (1998) Abdominal percutaneous interventional procedures: comparison of CT and US guidance. Radiology, 207, 705-710.