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The Annals of Thoracic Surgery Apr 2000Lung biopsy is commonly performed for diagnosis of diffuse pulmonary disease. The lingula offers technical advantages for biopsy, however the quality of tissue obtained...
BACKGROUND
Lung biopsy is commonly performed for diagnosis of diffuse pulmonary disease. The lingula offers technical advantages for biopsy, however the quality of tissue obtained by lingula biopsy has been questioned. We sought to determine whether lingula biopsy was a satisfactory site for biopsy in terms of diagnostic yield, therapeutic interventions, and survival results.
METHODS
All diagnostic lung biopsies performed for diffuse lung disease at 3 university affiliated hospitals between July 1, 1992 and December 31, 1998 were retrospectively reviewed. Patients were divided into 2 groups, depending upon site of biopsy: patients with lingula biopsy only and those with biopsies from other sites.
RESULTS
There were 75 patients; 20 underwent biopsy of the lingula alone, 48 had biopsy of other sites with or without biopsy of the lingula, and location of biopsy was unknown in 7 patients. Histologic diagnosis was achieved in all patients. Significant beneficial therapeutic changes were made in 14 lingula patients, and consisted of immunosuppression in 12 cases. Three patients died in the hospital or within 30 days. Fourteen patients survived 1 year. There was no significant difference between patients that had biopsy of the lingula alone and those that had biopsies from other sites in urgency, technique, histologic diagnosis, rate of therapeutic interventions, hospital mortality, or 1 year survival.
CONCLUSIONS
Lung biopsy of the lingula compared to other anatomic sites has equivalent diagnostic yield, therapeutic significance, and survival. Given the technical ease of biopsy, when disease is present radiographically it is the preferred site for lung biopsy.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Child; Female; Humans; Lung; Lung Diseases; Male; Middle Aged
PubMed: 10800786
DOI: 10.1016/s0003-4975(99)01565-9 -
Dermatologic Clinics Apr 2015Nail punch biopsy is used to obtain a tissue sample for the diagnosis and treatment of nail diseases. The best results will be possible if the surgeon is familiar with... (Review)
Review
Nail punch biopsy is used to obtain a tissue sample for the diagnosis and treatment of nail diseases. The best results will be possible if the surgeon is familiar with the anatomy and physiology of the nail apparatus. A punch biopsy can be used in all regions of the nail apparatus in the presence or absence of nail plate. When the procedure is performed with a careful handling of the anatomic site and specimen, in most cases a successful diagnosis can be achieved.
Topics: Anesthesia, Local; Biopsy; Humans; Nail Diseases; Nails; Specimen Handling
PubMed: 25828717
DOI: 10.1016/j.det.2014.12.008 -
The American Journal of Surgical... Jul 2017Kidney biopsies are conducted under varying scenarios, presenting variables that could potentially influence yield and adequacy of tissue collected. We retrospectively...
Kidney biopsies are conducted under varying scenarios, presenting variables that could potentially influence yield and adequacy of tissue collected. We retrospectively reviewed 636 native and allograft kidney biopsies, and compared tissue collected between differing practitioners performing the biopsy (nephrologists or radiologists), imaging modalities for guidance (ultrasound or computed tomography), gauge needle used (18 or 16 G), and between on-site evaluators of biopsy adequacy conducted at the time of biopsy (general pathologists, renal pathologists, nephrologists). For radiologists using ultrasound guidance and 18 G needles, those using on-site evaluation of adequacy collected more glomeruli and glomeruli per length of tissue core than those not using on-site evaluation. Radiologists not using on-site evaluation but who used a larger bore needle (16 vs. 18 G) could generally collect comparable tissue as other biopsy performers who used on-site evaluation. Radiologists performing ultrasound-guided biopsies with 18 G needles without on-site evaluation consistently provided poorer tissue yield and had a higher rate of providing insufficient tissue so that a diagnosis could not be rendered. Nephrologists collected less total length of tissue cores, glomeruli, and arteries per case (whether performing the biopsy and/or performing on-site adequacy) compared with other groups using on-site evaluation, however, providing comparable density of glomeruli and arteries. Complication rates did not differ between compared groups using 18 G needles. It is our observation that the various conditions by which a kidney biopsy is obtained influences the yield of tissue collected and the subsequent ability for a pathologist to effectively provide a diagnosis.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Female; Humans; Kidney; Kidney Transplantation; Male; Middle Aged; Outcome Assessment, Health Care; Retrospective Studies; Young Adult
PubMed: 28418995
DOI: 10.1097/PAS.0000000000000854 -
Digestive Diseases (Basel, Switzerland) 2023A variety of liver disorders are associated with characteristic histopathological findings that help in their diagnosis and treatment. However, percutaneous liver biopsy...
INTRODUCTION
A variety of liver disorders are associated with characteristic histopathological findings that help in their diagnosis and treatment. However, percutaneous liver biopsy (PLB) is prone to limitations and complications. We evaluated all PLBs done in our hospital in a 13-year period, aiming to assess PLB's utility and complications.
METHODS
All PLBs conducted in an internal medicine department of a tertiary university hospital in Athens, Greece, during a 13-year period were reviewed. Recorded data included demographic characteristics, laboratory results acquired on biopsy day, indication for liver biopsy, and occurrence of side effects. All patients were followed for 1 month post-hospital discharge for possible PLB-related complications.
RESULTS
A total of 261 patients underwent PLB during the study period. The commonest indication of PLB was investigation of liver mass, followed by transaminasemia. PLB assisted in setting a diagnosis in 218 patients and was unhelpful in only 43, in 14 of them due to inadequate or inappropriate biopsy specimen. Complications attributable to PLB were rare, with 10 patients exhibiting pain, either at biopsy site or in the right shoulder, and 3 having bleeding episodes; no deaths were noted.
CONCLUSIONS
Our study shows that PLB is still a powerful diagnostic tool in everyday practice, provided it is used when indicated.
Topics: Humans; Liver; Biopsy; Liver Diseases; Biopsy, Needle; Digestive System Surgical Procedures
PubMed: 37611545
DOI: 10.1159/000533328 -
Medicine Jul 2016Although there are general guidelines on endoscopic biopsy for diagnosing gastric neoplasms, they are predominantly based on outdated literature obtained with...
Understanding the diagnostic yield of current endoscopic biopsy for gastric neoplasm: A prospective single-center analysis based on tumor characteristics stratified by biopsy number and site.
Although there are general guidelines on endoscopic biopsy for diagnosing gastric neoplasms, they are predominantly based on outdated literature obtained with fiberscopes without analyses specific to tumor characteristics.This study aims to comprehensively characterize the contemporary endoscopic biopsy by determining the diagnostic yield across different lesion morphologies and histological stages, especially exploring how the number and site of biopsy may influence the overall yield.Biopsy samples from suspected gastric neoplasms were collected prospectively from May 2011 to August 2014 in a tertiary care medical center. A standardized methodology was used to obtain a total of 6 specimens from 2 defined sites per lesion. Rate of positive diagnosis based on the biopsy number and site was assessed for specific gastric lesion morphologies and histological stages.A total of 1080 biopsies from 180 pathologically diagnosed neoplastic lesions in 176 patients were obtained during the study. For depressed/ulcerative and polypoid lesions, the yield was already >99% by the fourth biopsy without further gain from additional biopsies. Lower overall yield was observed for infiltrative lesions (57.1% from 4 biopsies). The site of biopsy did not influence the diagnostic yield except for with infiltrative lesions in which biopsies from thickened mucosal folds were of higher yield than erosive regions.Obtaining 4 specimens may be sufficient for accurate diagnosis of a depressed/ulcerative or polypoid gastric lesion regardless of its histological stage. For infiltrative lesions, at least 5 to 6 biopsies per lesion with more representative sampling from thickened mucosal folds may be preferable.
Topics: Aged; Biopsy; Female; Gastroscopy; Humans; Male; Neoplasm Staging; Prospective Studies; Stomach Neoplasms
PubMed: 27472689
DOI: 10.1097/MD.0000000000004196 -
European Journal of Radiology May 2017Ultrasonography (US) is a readily available non-invasive tool useful for the detection of musculoskeletal and soft tissue masses. Although X-Ray is often the first... (Review)
Review
Ultrasonography (US) is a readily available non-invasive tool useful for the detection of musculoskeletal and soft tissue masses. Although X-Ray is often the first imaging study for evaluating both bone and soft tissue lesions, and magnetic resonance imaging and computed tomography are mandatory in lesions staging, US is increasingly used for the early assessment of musculoskeletal and soft-tissue masses and for guiding procedures and biopsies. Surgical biopsy or fine needle aspiration biopsy (FNAB) is needed to ascertain the nature of any lesion. FNAB is a low cost technique, safer and less traumatic than an open surgical biopsy. Significant complications are rare, mostly related to the site of biopsy. Knowledge of indications, limitations, anatomical and pathological access, adequate technical expertise in US imaging and in intervention skills are the critical factors of the appropriate and safe use of FNAB. By now, the role of FNAB in musculoskeletal diseases is controversial and there is still a heated debate in the scientific community.
Topics: Biopsy, Fine-Needle; Female; Humans; Image-Guided Biopsy; Male; Musculoskeletal Diseases; Ultrasonography, Interventional
PubMed: 28583640
DOI: 10.1016/j.ejrad.2017.02.042 -
Surgical Technology International 2003Percutaneous biopsy of the liver is the most specific test available currently to assess the nature and severity of liver diseases. Image-guidance either before or... (Review)
Review
Percutaneous biopsy of the liver is the most specific test available currently to assess the nature and severity of liver diseases. Image-guidance either before or during the procedure has allowed this technique to be performed on a routine basis. The purpose of this article was to review the indications and contraindications for performing liver biopsy, and describe the spectrum of major and minor complications that can occur following biopsy. Equipment and biopsy needles available currently were compared, and the individual steps involved in ultrasound-guided biopsies described. Blinded versus ultrasound-guided biopsies were compared, and techniques used for selecting the most appropriate site for biopsy, reducing the passes through the liver, and reducing complications were discussed.
Topics: Biopsy, Needle; Equipment Design; Equipment Safety; Female; Humans; Liver Diseases; Liver Neoplasms; Male; Risk Assessment; Sensitivity and Specificity; Ultrasonography, Interventional
PubMed: 12931297
DOI: No ID Found -
AJR. American Journal of Roentgenology Oct 2006We have developed a new CT-guided technique using puncture site-down positioning during the biopsy. The goal of our study was to determine the efficacy and safety of... (Comparative Study)
Comparative Study
OBJECTIVE
We have developed a new CT-guided technique using puncture site-down positioning during the biopsy. The goal of our study was to determine the efficacy and safety of this technique for biopsy of lung lesions compared with the standard technique.
MATERIALS AND METHODS
Medical records of 236 patients who underwent CT-guided transthoracic needle biopsy were retrospectively evaluated. This study included 89 cases that were biopsied using the standard technique (group A) and 147 cases that were biopsied using the puncture site-down positioning technique (group B). A 20-gauge automated cutting needle without coaxial technique was used in all patients. Medical records were reviewed for lesion size and location, biopsy results, and complications.
RESULTS
When using the standard technique, the sensitivity for malignant lesions was 96.1%; the sensitivity for benign lesions, 92.1%; and diagnostic accuracy, 94.4%. Thirty-seven patients (41.6%) had pneumothorax, with 16 (18.0%) requiring chest tube placement. When using the puncture site-down positioning technique, the sensitivity for malignant lesions was 95.4%; the sensitivity for benign lesions, 93.3%; and diagnostic accuracy, 94.6%. Nineteen patients (12.9%) had pneumothorax, with four (2.7%) requiring chest tube placement. Other complications were minimal.
CONCLUSION
CT-guided transthoracic needle biopsy using the puncture site-down positioning technique is an effective and safe procedure with a high diagnostic accuracy and low complication rate. This new technique is especially useful in reducing the rate of pneumothorax.
Topics: Adult; Aged; Aged, 80 and over; Biopsy, Needle; Female; Humans; Lung; Lung Diseases; Male; Middle Aged; Pneumothorax; Punctures; Radiography, Interventional; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 16985136
DOI: 10.2214/AJR.05.0226 -
The Journal of Urology Oct 1999We determine whether site specific labeling of sextant prostate biopsy cores predicts the site of extracapsular extension in a radical prostatectomy specimen, thereby... (Clinical Trial)
Clinical Trial
PURPOSE
We determine whether site specific labeling of sextant prostate biopsy cores predicts the site of extracapsular extension in a radical prostatectomy specimen, thereby justifying increased cost of pathological evaluation.
MATERIALS AND METHODS
Between January 1994 and December 1997, 407 radical prostatectomies were performed at our institution by a single surgeon (H. L.). Surgical specimens showing extracapsular extension were examined by a single pathologist (J. M.) to identify the site of extension. Several different methods of submitting transrectal ultrasound guided biopsy cores were used since the majority of cases did not undergo biopsy at our institution. In 243 cases sextant biopsies were labeled right versus left. Of these cases 103 specimen cores were individually labeled. The ability of the positive biopsy core location to predict the location of extracapsular extension in the surgical specimen was determined. Univariate and multivariate logistic regression analyses were performed to assess the ability of biopsy core characteristics, including Gleason score, percentage of cancer in the core, core location and number of positive cores in the specimen, to predict the site of extracapsular extension. A similar analysis was performed for the 243 cases with right versus left core labeling.
RESULTS
The positive predictive value was 8.9+/-2.2% for a single positive core to identify the location of extracapsular extension correctly in the individually labeled core cases. The absence of cancer in a sextant biopsy had a negative predictive value of 96.9+/-1.4%. The overall sensitivity was 59.4+/-3.8% for a positive biopsy core. In the right versus left core cases the positive predictive value was 12.9+/-3.0% with a sensitivity of 85.1+/-3.2%. In an individual core Gleason score 8 or greater and/or cancer in more than 50% of tissue enhanced the positive predictive value but not to a clinically useful level. Multivariate logistic regression identified Gleason score, number of positive ipsilateral cores and base position of the positive biopsy as the most predictive variables for the site of extracapsular extension.
CONCLUSIONS
When submitting biopsy specimens by individually labeled core or right versus left core, the positive predictive value of an individual positive core for the location of extracapsular extension is not sufficient to guide the surgical decision to spare or excise a neurovascular bundle. Therefore, the clinical information provided by individually labeled or right versus left core labeling does not justify the increased associated costs.
Topics: Biopsy; Humans; Male; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Staging; Predictive Value of Tests; Prostatectomy; Prostatic Neoplasms; Sensitivity and Specificity
PubMed: 10492195
DOI: No ID Found -
Current Gastroenterology Reports Feb 2004Liver biopsy continues to have a central role in the evaluation of patients with suspected liver disease. The procedure is often indicated to evaluate otherwise... (Comparative Study)
Comparative Study Review
Liver biopsy continues to have a central role in the evaluation of patients with suspected liver disease. The procedure is often indicated to evaluate otherwise unexplained liver biochemical test abnormalities, but the precise degree of serum aminotransferase elevations that should prompt a liver biopsy is controversial, as is the need for liver biopsy in all patients with suspected nonalcoholic fatty liver disease and chronic hepatitis C. Standard liver biopsy is contraindicated in patients with severe coagulopathy and ascites, although the degree of coagulopathy that contraindicates a liver biopsy is controversial. A transjugular approach is an alternative in patients with coagulopathy or ascites. Controversy surrounds all the technical aspects of liver biopsy, particularly the choice of needle (cutting vs suction) and the use of ultrasound to mark or guide the biopsy site. Bleeding is the major complication of liver biopsy, with a risk of 0.3%; cutting needles are more likely to cause hemorrhage than are suction needles. Traditionally, liver biopsy has been the province of the hepatologist/ gastroenterologist. However, an increasing number of liver biopsies are performed by radiologists. The implications of this trend with respect to patient outcome, safety, and training of fellows is unclear.
Topics: Biopsy, Needle; Female; Guidelines as Topic; Humans; Liver Diseases; Male; Risk Assessment; Sensitivity and Specificity
PubMed: 14720451
DOI: 10.1007/s11894-004-0023-4