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Respiratory Medicine Nov 2023New tools such as cryobiopsy of mediastinal lymph nodes (cryoEBUS) have been described to improve the diagnostic usefulness of endobronchial ultrasound-guided... (Meta-Analysis)
Meta-Analysis Review
Is the diagnostic yield of mediastinal lymph node cryobiopsy (cryoEBUS) better for diagnosing mediastinal node involvement compared to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)? A systematic review.
INTRODUCTION
New tools such as cryobiopsy of mediastinal lymph nodes (cryoEBUS) have been described to improve the diagnostic usefulness of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The literature suggests that this novel procedure could be associated with greater diagnostic usefulness than conventional EBUS-TBNA.
METHODS
To develop a systematic analysis and meta-analysis on the diagnostic diagnostic yield and safety of cryobiopsy of hilar and mediastinal adenopathies compared to EBUS-TBNA.
RESULTS
Seven studies that had included a total of 555 patients were considered in this review, with 365 (65.7%) of these patients having an etiology of malignant lymph node involvement. The overall diagnostic usefulness of cryoEBUS was higher compared to EBUS-TBNA (92% vs. 80%). However, when the results were analysed according to the specific aetiologies of the adenopathies, cryoEBUS was especially useful in cases of lymphomas or non-pulmonary carcinomas (83% vs. 42%) and in cases that were benign (87% vs. 60.1%), with no significant differences being found in specific cases of lung cancer. For lymphoma, cryoEBUS was diagnostic in 87% of cases compared to 12% for EBUS-TBNA and in addition, also allowed the characterisation of every lymphoma subtype. Genetic studies and immunohistochemical determination of PD-L1 was possible in almost all (97%) of the samples obtained by cryoEBUS, while this was only possible in 79% of those obtained by EBUS-TBNA. The most frequent complication was light bleeding, which was described in up to 85% of cases in some series.
CONCLUSION
CryoEBUS could represent a promising technique in the diagnostic algorithm used for mediastinal and hilar involvement. Although cryoEBUS did not significantly improve the diagnosis of lung cancer compared to EBUS-TBNA, the results were significantly better in patients with benign pathologies and other tumour types, including lymphomas. In addition, it seems that the samples obtained by cryoEBUS better defined the histological subtypes of lymphoma and allowed complete molecular characterisation in cases of lung cancer. The technique has proven to be safe and no serious complications were described after the procedure.
Topics: Humans; Bronchoscopy; Mediastinum; Lymph Nodes; Lung Neoplasms; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Lymphadenopathy; Lymphoma; Retrospective Studies
PubMed: 37579981
DOI: 10.1016/j.rmed.2023.107389 -
American Journal of Clinical Pathology Feb 2022Small-volume biopsy-fine-needle aspiration biopsy (FNAB) with or without core biopsy-is in increasing use in diagnosis and management of lymphoma patients. Our objective...
OBJECTIVES
Small-volume biopsy-fine-needle aspiration biopsy (FNAB) with or without core biopsy-is in increasing use in diagnosis and management of lymphoma patients. Our objective was to survey the current practice in small-volume biopsy diagnosis of lymphoma, focusing on the interaction among hematopathologists and cytopathologists and the integration of FNAB, core biopsy, and flow cytometry studies at sign-out.
METHODS
This study used a cross-sectional survey design employing the RedCap database distributed via nine pathology professional society email listservs. The survey consisted of 25 multiple-choice questions and several free text fields. In total, 128 pathologists participated.
RESULTS
Most respondents indicated that FNAB specimens in which lymphoma is a diagnostic consideration (FNAB-L) are seen daily or weekly (68/116; 58.6%). However, most institutions have separate hematopathology and cytopathology services (72/116; 62.1%) with inconsistent communication. When communication occurred, respondents were frequently inclined to reconsider their original diagnoses. Barriers identified included lack of communication, inadequate access to diagnostic studies, no formal subspecialty training, and various opinions regarding FNAB in diagnosing lymphoma.
CONCLUSIONS
This survey showed that FNAB-L specimens are common, with a lack of uniformity in how complementary fine-needle aspiration and core biopsy specimens or flow immunophenotyping results are shared across hematopathology and cytopathology services.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Cross-Sectional Studies; Humans; Immunophenotyping; Pathologists
PubMed: 34508545
DOI: 10.1093/ajcp/aqab111 -
Journal of Clinical Oncology : Official... Mar 2022
Topics: Adult; Biopsy, Needle; Female; Humans; Lymphoma; Mental Health; Physicians
PubMed: 34874754
DOI: 10.1200/JCO.21.01523 -
Clinics in Liver Disease Feb 2022Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a safe and effective alternative to percutaneous and trans-jugular approaches for hepatic tissue... (Review)
Review
Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a safe and effective alternative to percutaneous and trans-jugular approaches for hepatic tissue acquisition. It has shown superior diagnostic yield for the targeted approach of focal lesions, less sampling variability, improved patient comfort, and safety profile. These advantages have contributed to the increased use of EUS-LB as a technique for obtaining liver tissue. In this review, we provide an update on the recent evidence of EUS-LB for the evaluation of liver disease.
Topics: Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Image-Guided Biopsy; Liver Diseases; Ultrasonography
PubMed: 34802658
DOI: 10.1016/j.cld.2021.09.002 -
Neuroimaging Clinics of North America Nov 2019Fine-needle aspiration (FNA) and core needle biopsy are the primary diagnostic modalities for assessing mass lesions. Any superficial or deep-seated lesion occurring... (Review)
Review
Fine-needle aspiration (FNA) and core needle biopsy are the primary diagnostic modalities for assessing mass lesions. Any superficial or deep-seated lesion occurring anywhere in the body, including bone and soft tissue, can undergo this procedure to pathologically characterize it. The outcomes of FNA, performed either alone or in combination with core biopsy, are best when performed and interpreted by skilled individuals. The roles of interventional radiologists and cytologists are pivotal in ensuring adequacy of the specimen and leading the clinical team in making the diagnosis and avoiding repeat diagnostic procedures or a more invasive open surgical biopsy.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Humans; Spinal Neoplasms; Spine
PubMed: 31677735
DOI: 10.1016/j.nic.2019.07.009 -
Radiology Jan 2023
Topics: Humans; Fibrinolytic Agents; Hematoma; Breast; Biopsy, Large-Core Needle
PubMed: 35997611
DOI: 10.1148/radiol.221871 -
Der Pathologe Nov 2021Prostate cancer is the most prevalent noncutaneous cancer in men. The Gleason grading is considered to be the strongest prognostic parameter regarding progression-free...
Prostate cancer is the most prevalent noncutaneous cancer in men. The Gleason grading is considered to be the strongest prognostic parameter regarding progression-free survival and overall survival. The original grading system has been modified during the last decade resulting in a more precise prognostic tool. The pretreatment Gleason score guides clinical management and is a key component in S3 guidelines for prostate cancer. In addition to Gleason score several other histologic findings in prostate needle biopsy influence patient management. In this second part of our CME series about prostate cancer, we will discuss the diagnosis of prostate cancer and current guidelines for reporting prostate cancer. In addition, we will highlight prostate lesions of urothelial origin and neuroendocrine prostate cancer as well as prognostic biomarkers.
Topics: Biopsy, Needle; Humans; Male; Neoplasm Grading; Prognosis; Prostatectomy; Prostatic Neoplasms
PubMed: 34648048
DOI: 10.1007/s00292-021-00997-8 -
The Journal of Thoracic and... Jan 2022
Topics: Aortic Valve Stenosis; Biopsy, Needle; Humans; Postoperative Complications
PubMed: 33863493
DOI: 10.1016/j.jtcvs.2021.03.056 -
The Journal of Thoracic and... May 2020
Topics: Autophagy; Biopsy, Needle; Endosonography
PubMed: 31987610
DOI: 10.1016/j.jtcvs.2019.11.058 -
Gastrointestinal Endoscopy Jul 2020
Topics: Biopsy, Needle; Humans; Pancreatic Cyst
PubMed: 32586563
DOI: 10.1016/j.gie.2020.03.017