Skip to main content

Advertisement

Springer Nature Link
Log in

Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma—experience at the Lymph Node Registry Kiel

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Swerdlow SH, Campo E, Harris N, Jaffe E, Pileri S, Stein H, Thiele J, Vardiman JW (2008) WHO classification of tumors of the haematopoietic and lymphoid tissues. IARC, Lyon

    Google Scholar 

  2. Dreyling M, Geisler C, Hermine O, Kluin-Nelemans HC, Le GS, Rule S, Shpilberg O, Walewski J, Ladetto M (2014) Newly diagnosed and relapsed mantle cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25(Suppl 3):iii83–iii92

    Article  PubMed  Google Scholar 

  3. Eichenauer DA, Engert A, Andre M, Federico M, Illidge T, Hutchings M, Ladetto M (2014) Hodgkin’s lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25(Suppl 3):iii70–iii75

    Article  PubMed  Google Scholar 

  4. Dreyling M, Ghielmini M, Marcus R, Salles G, Vitolo U, Ladetto M (2014) Newly diagnosed and relapsed follicular lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25(Suppl 3):iii76–iii82

    Article  PubMed  Google Scholar 

  5. Tilly H, da Gomes SM, Vitolo U, Jack A, Meignan M, Lopez-Guillermo A, Walewski J, Andre M, Johnson PW, Pfreundschuh M, Ladetto M (2015) Diffuse large B-cell lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 26(Suppl 5):v116–v125

    Article  PubMed  Google Scholar 

  6. de Kerviler E, Guermazi A, Zagdanski AM, Meignin V, Gossot D, Oksenhendler E, Mariette X, Brice P, Frija J (2000) Image-guided core-needle biopsy in patients with suspected or recurrent lymphomas. Cancer 89:647–652

    Article  PubMed  Google Scholar 

  7. Burke C, Thomas R, Inglis C, Baldwin A, Ramesar K, Grace R, Howlett DC (2011) Ultrasound-guided core biopsy in the diagnosis of lymphoma of the head and neck. A 9 year experience. Br J Radiol 84:727–732

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hu Q, Naushad H, Xie Q, Al-Howaidi I, Wang M, Fu K (2013) Needle-core biopsy in the pathologic diagnosis of malignant lymphoma showing high reproducibility among pathologists. Am J Clin Pathol 140:238–247

    Article  PubMed  Google Scholar 

  9. Skelton E, Jewison A, Okpaluba C, Sallomi J, Lowe J, Ramesar K, Grace R, Howlett DC (2015) Image-guided core needle biopsy in the diagnosis of malignant lymphoma. Eur J Surg Oncol 41:852–858

    Article  CAS  PubMed  Google Scholar 

  10. Nguyen BM, Halprin C, Olimpiadi Y, Traum P, Yeh JJ, Dauphine C (2014) Core needle biopsy is a safe and accurate initial diagnostic procedure for suspected lymphoma. Am J Surg 208:1003–1008

    Article  PubMed  Google Scholar 

  11. Screaton NJ, Berman LH, Grant JW (2002) Head and neck lymphadenopathy: evaluation with US-guided cutting-needle biopsy. Radiology 224:75–81

    Article  PubMed  Google Scholar 

  12. Demharter J, Neukirchen S, Wagner T, Schlimok G, Bohndorf K, Kirchhof K (2007) Do ultrasound-guided core needle biopsies of lymph nodes allow for subclassification of malignant lymphomas? Röfo 179:396–400

    CAS  PubMed  Google Scholar 

  13. Shimizu I, Okazaki Y, Takeda W, Kirihara T, Sato K, Fujikawa Y, Ueki T, Hiroshima Y, Sumi M, Ueno M, Ichikawa N, Kobayashi H (2014) Use of percutaneous image-guided coaxial core-needle biopsy for diagnosis of intraabdominal lymphoma. Cancer Med 3:1336–1341

    Article  PubMed  PubMed Central  Google Scholar 

  14. Frederiksen JK, Sharma M, Casulo C, Burack WR (2015) Systematic review of the effectiveness of fine-needle aspiration and/or core needle biopsy for subclassifying lymphoma. Arch Pathol Lab Med 139:245–251

    Article  PubMed  Google Scholar 

  15. Hehn ST, Grogan TM, Miller TP (2004) Utility of fine-needle aspiration as a diagnostic technique in lymphoma. J Clin Oncol 22:3046–3052

    Article  PubMed  Google Scholar 

  16. Pruneri G, Gigli F, Rafaniello Raviele P, Gardellini A, Raimondi S, De Fiori E, Preda L, Viale G, Martinelli G, Laszlo D (2015) Core needle biopsy as a front line diagnostic approach for lymphoma patients. Hematol Oncol 33(4):247–249

    Article  PubMed  Google Scholar 

  17. Dong HY, Harris NL, Preffer FI, Pitman MB (2001) Fine-needle aspiration biopsy in the diagnosis and classification of primary and recurrent lymphoma: a retrospective analysis of the utility of cytomorphology and flow cytometry. Mod Pathol 14:472–481

    Article  CAS  PubMed  Google Scholar 

  18. Caraway NP (2015) Evolving role of FNA biopsy in diagnosing lymphoma: past, present, and future. Cancer Cytopathol 123:389–393

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Susanne Griep and Susanne Pietz for their excellent technical support, and Kay Dege for the language editing. We are indebted to all collaborating pathologists, oncologists, surgeons, and interventional radiologists.

Author information

Authors and Affiliations

  1. Department of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Campus Kiel/Christian-Albrecht University, Arnold-Heller-Str. 3, Haus 14, 24105, Kiel, Germany

    Alice Johl & Wolfram Klapper

  2. 3rd Department of Internal Medicine, University Hospital Mannheim, Mannheim, Germany

    Eva Lengfelder

  3. Department of Internal Medicine III, University Hospital of Munich, Munich, Germany

    Wolfgang Hiddemann

Authors
  1. Alice Johl
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Eva Lengfelder
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Wolfgang Hiddemann
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Wolfram Klapper
    View author publications

    You can also search for this author inPubMed Google Scholar

Consortia

the German Low-grade Lymphoma Study Group (GLSG)

Corresponding author

Correspondence to Wolfram Klapper.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

Number of analysis and time to diagnosis in core needle biopsy (CNB) or surgical excision biopsy (SEB). P-value according to t-Test and Fischer’s Exact Test. SEM: standard error of mean. (XLSX 11 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Johl, A., Lengfelder, E., Hiddemann, W. et al. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma—experience at the Lymph Node Registry Kiel. Ann Hematol 95, 1281–1286 (2016). https://doi.org/10.1007/s00277-016-2704-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-016-2704-0

Keywords