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Introducción: La biopsia percutánea se ha convertido, en nuestros días, en el método diagnóstico más utilizado para la evaluación de las lesiones de mama sospechosas de malignidad. Objetivo: Caracterizar los resultados de biopsia por trucut en pacientes con categorías BI-RADS 4 y 5 sin criterio quirúrgico. Materiales y métodos: Se realizó un estudio observacional, descriptivo y transversal de 70 pacientes que presentaron lesión sospechosa de malignidad por ultrasonografía y que requirieron la realización de biopsia por aguja gruesa de la imagen reportada, entre enero de 2019 y diciembre de 2020. Se realizaron en la Consulta de Intervencionismo Mamario del Departamento de Imagenología del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas. Se analizaron las variables edad, categoría BI-RADS, resultado histopatológico, tamaño tumoral y complicaciones. Resultados: El grupo etario predominante fue el de 70-79 años (27,1). Se clasificaron 48 pacientes con categoría BI-RADS 5, para un 68,6 %. El carcinoma ductal infiltrante resulto ser el tipo histológico predominante, con 40 pacientes, representando el 57,1 % del total. Se obtuvo una media de 28,91 mm de diámetro de las lesiones biopsiadas. Todas las muestras resultaron útiles, aun en diámetros transversales inferiores a 2 cm. En la serie, las complicaciones reportadas fueron escasas. Conclusiones: La biopsia realizada con aguja gruesa bajo guía ecográfica con técnica de manos libres, es un método confiable para el diagnóstico de cáncer de mama, seguro y sin complicaciones graves. Se confirma que la categoría BI-RADS 5 coincide con diagnóstico histopatológico de cáncer mamario.
Introduction: Percutaneous biopsy has become, nowadays, the most used diagnostic method to evaluate breast lesions suspected of malignancy. Objective: To characterize the Tru-cut biopsy results in patients with BI-RADS 4 and 5 categories without surgical criteria. Materials and methods: An observational, descriptive and cross-sectional study was carried out between January 2019 and December 2020 on 70 patients who presented who presented a lesion suspicious of malignancy by ultrasonography and required a thick-needle biopsy of the reported image. They were performed at the Breast Intervention Clinic of the Imaging Department of the Clinical Surgical University Hospital Comandante Faustino Pérez Hernández, from Matanzas. The variables age, BI-RADS category, histopathological result, tumor size and complications were analyzed. Results: The predominant age group was the 70-79 years-old one (27.1). 48 patients were classified with BI-RADS 5 category, for 68.6%. Infiltrating ductal carcinoma resulted the predominant histological type, with 40 patients representing 57.1% of the total. An average diameter of 28.91 mm was obtained from the biopsied lesions. All samples were useful, even in transverse diameters less than 2cm. In the series, few complications were reported. Conclusion: Biopsy performed with thick needle under ultrasound guidance with free-hands technique, is a reliable method for breast cancer diagnosis, safe and without serious complications. It is confirmed that BI-RADS 5 category coincides with breast cancer pathological diagnosis.
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Resumo Objetivo: Avaliar o desempenho diagnóstico da biópsia pulmonar percutânea transtorácica (BPPT) guiada por fluoroscopia associada a tomografia computadorizada (FTC) em nódulos pulmonares ≤ 10 mm no período de pandemia de COVID-19. Materiais e Métodos: No período de 1º de janeiro de 2020 a 30 de abril de 2022, 359 BPPTs guiadas por FTC foram realizadas em um centro terciário de radiologia intervencionista. As lesões pulmonares mediam entre 2 mm e 108 mm. Dessas 359 BPPTs, 27 (7,5%) foram realizadas com agulha 18G em nódulos de 2 mm a 10 mm. Resultados: Das 27 BPPTs realizadas nos nódulos ≤ 10 mm, quatro lesões tinham dimensões menores que 5 mm e 23 lesões mediam entre 5 e 10 mm. Sensibilidade e acurácia diagnóstica das BPPTs guiadas por FTC foram de 100% e 92,3%, respectivamente. A dose média de radiação ionizante para os pacientes durante o procedimento de BPPT guiada por FTC foi de 581,33 mGy*cm, variando de 303 a 1129 mGy*cm. A média de tempo dos procedimentos de biópsia foi de 6,6 minutos, variando de 2 a 12 minutos. Nas 27 BPPTs, nenhuma complicação maior foi descrita. Conclusão: A BBPT guiada por FTC resultou em alto rendimento diagnóstico e baixas taxas de complicações.
Abstract Objective: To evaluate the diagnostic performance of computed tomography (CT) fluoroscopy-guided percutaneous transthoracic needle biopsy (PTNB) in pulmonary nodules ≤ 10 mm during the coronavirus disease 2019 pandemic. Materials and Methods: Between January 1, 2020 and April 30, 2022, a total of 359 CT fluoroscopy-guided PTNBs were performed at an interventional radiology center. Lung lesions measured between 2 mm and 108 mm. Of the 359 PTNBs, 27 (7.5%) were performed with an 18G core needle on nodules ≤ 10 mm in diameter. Results: Among the 27 biopsies performed on nodules ≤ 10 mm, the lesions measured < 5 mm in four and 5-10 mm in 23. The sensitivity and overall diagnostic accuracy of PTNB were 100% and 92.3%, respectively. The mean dose of ionizing radiation during PTNB was 581.33 mGy*cm (range, 303-1,129 mGy*cm), and the mean biopsy procedure time was 6.6 min (range, 2-12 min). There were no major postprocedural complications. Conclusion: CT fluoroscopy-guided PTNB appears to provide a high diagnostic yield with low complication rates.
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Resumen Las biopsias percutáneas a nivel de la pelvis plantean un desafío dada la compleja anatomía regional. El conocimiento de las estructuras afectadas y el tipo de lesión a intervenir son algunos de los aspectos que van a influenciar la técnica que se utilice. Se han propuesto distintas vías de abordaje, pero aún carecen de sistematización. El objetivo de este artículo es destacar accesos seguros ejemplificando con casos ilustrativos de nuestra institución. Además, agregamos comentarios basados en nuestra experiencia.
Abstract Pelvic percutaneous biopsies are challenging due to complex regional anatomy. Knowledge of affected structures and lesion type are some of the aspects that will condition the technique applied. Different approaches to pelvic percutaneous biopsies have been proposed, but still lack systematization. The aim of this article is to highlight safe approaches supported with illustrative cases. Furthermore, we provide opinion based on our experience.
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Objective • To investigate the clinical value of 18F-flurodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/ CT)-guided percutaneous biopsy in peritoneal thickening of unknown origin. Methods • Ten cases of peritoneal thicken of unknown origin including 4 males and 6 females were analyzed. After 18F-FDG PET/CT examination, the peritoneal thickening regions with high 18F-FDG uptake were selected for the target areas. Percutaneous biopsy was operated under the guidance of the same PET/CT machine. Results • All lesions were successfully obtained by one-time puncture without serious complications, and histopathological diagnosis revealed that 7 cases were malignant, including 4 cases of peritoneal metastasis and 3 cases of lymphoma. The remaining cases were 1 case of pseudomyxoma, 1 case of tuberculosis and 1 case of inflammatory lesions. The accuracy of biopsy was 100%. Conclusion • 18F-FDG PET/CT-guided peritoneal percutaneous biopsy is a safe and effective method, and may play an important role in differential diagnosis and treatment management.
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Objetivos Describir la experiencia inicial en el uso de un sistema de biopsia por vacío con guía estereotáxica digital para lesiones mamarias. Material y método Se evaluaron retrospectivamente las biopsias bajo estereotaxia mamográfica con sistema de vacío (bav) realizadas en el Centro de Imagenología Mamaria (imad) de la ciudad de Bahía Blanca desde marzo de 2016 a julio de 2017. En el período analizado, se recibieron 329 pedidos de punción, de los cuales 112 correspondieron a biopsias bajo estereotaxia mamográfica con sistema de vacío y 217 a biopsias bajo ecografía. Se realizaron 99/112 (89%) bav, no pudiéndose completar el procedimiento en 13/112 (11%) de los casos. Resultados Se obtuvieron los siguientes resultados patológicos: 20% (20/99) Maligno, 7% (7/99) Alto riesgo y 73% (72/99) Benigno. Se produjeron complicaciones leves que no requirieron ningún tipo de tratamiento posterior en el 8% de los casos: 7/99 reacción vasovagal y 1/99 dolor que dificultó el procedimiento, aunque en todos los casos se pudo finalizar el mismo. Conclusiones Se diagnosticaron lesiones malignas o de alto riesgo en el 27% de los procedimientos realizados.
Objectives To describe our initial experience with vacuum assisted breast biopsies under stereotactic guidance for non-palpable lesions. Materials and method We retrospectively review the vacuum assisted breast biopsies performed at Centro de Imagenología Mamaria (imad) between march 2016 and july 2017. 329 patients requested a breast biopsy. Of them, 112 were vacuum assisted biopsies under stereotactic guidance and 217 were ultrasound guided. We succesfully completed 99/112 (89%) of vacuum assisted biopsies, not being able to reach the target in the remaining 11%. Results The following pathological results were obtained: 20% (20/99) Malignant, 7% (7/99) High risk and 73% (72/99) Benign lesions. Minor complications, which did not require any further treatment, occurred in 8% of cases: 7/99 vasovagal reactions, 1/99 pain during the procedure. Conclusions Malignant and high-risk lesions were diagnosed in 27% of the procedures performed.
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Humans , Female , Breast Neoplasms , Biopsy , RadiosurgeryABSTRACT
Objective To evaluate the value of clinical application in chest tumor biopsy by DSA rotating reconstruction technology and CT guided technology.Methods The 63 cases of chest tumors collected,38 cases of lung tumors,25 cases of mediastinal tumors.Applicating of CT and DSA scan and formulating puncture path,according to their respective descending thoracic tumor puncture guide way.DSA and CT guided traditional way from the success rate of puncture,operation time,X-ray exposure and complications were analyzed.Results 45 cases take CT guidance,18 cases take DSA guidance.60 cases,the pathological results achieved and positive rate was 95.2％.CT group success rate of first puncture in 68.9％ (31/45),DSA group 88.9％ (16/18),statistically significant.CT group pneumothorax rate 17.8 ％ (8/45),DSA group pneumothorax rate 11.1％ (2/18),no statistical difference.Operation time CT group (23.111 ± 4.281) minutes,DSA group (12.889 ± 3.693) minutes,with significantly statistical differences.CT group exposure (11.563±3.023) mGy,DSA group exposure (9.956±2.193) mGy,statistically significant.Conclusion The chest tumor puncture biopsy by DSA rotating reconstruction technique guided with flexible,fast and convenient,and superior to traditional CT with real-time monitoring,shorten the operation time,reduce the exposure,the success rate of first puncture aspects.
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This study aimed to investigate the feasibility of the establishment of a human cancer xenograft model using samples from computed tomography (CT)-guided percutaneous biopsy. Fresh tumor tissues obtained from 10 cancer patients by CT-guided percutaneous biopsy were subcutaneously inoculated into NOD-Prkdcem26Il2rgem26Nju (NCG) mice to establish human patient-derived tumor xenograft (PDTX) models. The formation of first and second generation xenografts was observed, and tumor volume was recorded over time. Tumor tissue consistency between the PDTX model and primary tumors in patients was compared using H&E staining and immunohistochemistry. Pharmacodynamic tests of clinically used chemotherapeutic drugs were conducted on second generation xenografts, and their effects on tumor growth and body weight were observed. CT-guided percutaneous biopsy samples were successfully collected from 10 patients with advanced cancers. The PDTX model was established in mice using tumor samples obtained from 4 cancer patients, including one small cell carcinoma sample, two adenocarcinoma samples, and one squamous cell carcinoma sample. The success rate was 40%. The obtained PDTX model maintained a degree of differentiation, and morphological and structural characteristics were similar to primary tumors. The pharmacodynamic test of chemotherapeutic drugs in the PDTX model revealed a therapeutic effect on tumor growth, as expected. CT-guided percutaneous biopsy samples can be effectively used to establish a PDTX model, and test these chemotherapy regimens.
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Humans , Animals , Male , Female , Middle Aged , Aged , Adenocarcinoma/pathology , Disease Models, Animal , Liver Neoplasms/pathology , Lung Neoplasms/pathology , Xenograft Model Antitumor Assays/methods , Antineoplastic Agents/pharmacokinetics , Deoxycytidine/analogs & derivatives , Deoxycytidine/pharmacokinetics , Feasibility Studies , Image-Guided Biopsy/methods , Mice, Inbred Strains , Organoplatinum Compounds/pharmacokinetics , Tomography, X-Ray Computed , Xenograft Model Antitumor Assays/instrumentationABSTRACT
Objective To investigate the diagnostic accuracy factors for CT-guided percutaneous biopsy of spine lesions.Methods The clinical and pathological data of 128 patients who were undergone CT-guided percutaneous biopsy of spine lesions were collected.The multivariate stepwise Logistic retrospective study was performed to study the influence of the patient-related factors (sex,age),lesion-related factors (location,bone destruction characteristics,with or without necrosis,with or without calcification),and procedure factors (punc-ture target spot,tissue specimen size)on the diagnostic accuracy.Results The diagnostic accuracy rate of CT-guided percutaneous biopsy of spine lesions was 86.7% (1 1 1/128 ).By multi-factor analysis,bone destruction characteristics (OR = 3.428,P = 0.038 ),with or without necrosis (OR=0.1 93,P =0.012),with or without calcification (OR=0.266,P =0.036),tissue specimen size (OR=0.200, P =0.01 5)were incorporated into the regression equation of the diagnostic accuracy.Conclusion CT-guided percutaneous biopsy of spine lesions has a high diagnostic accuracy.Bone destruction characteristics,with or without necrosis,with or without calcification, tissue specimen size are the independent factors.
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Objective Undertaking of a complete audit of the service of mammography, as recommended by BI-RADS®, in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature. Materials and Methods Retrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012. Results The radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%. Conclusion The complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates. .
Objetivo Realização de auditoria completa do serviço de mamografia de uma instituição privada, conforme preconizado pelo BI-RADS®, e comparação dos resultados obtidos com os recomendados pela literatura em serviço de referência em diagnóstico de câncer mamário na cidade de São Paulo. Materiais e Métodos Estudo retrospectivo, analítico e transversal contendo casuística de 8.000 pacientes que realizaram mamografias no período de abril de 2010 a março de 2011, submetidas à auditoria, com base no resultado de sua mamografia. Houve seguimento dessas pacientes até dezembro de 2012. Resultados De acordo com a categorização BI-RADS, a classificação radiológica das 7.249 mamografias de rastreamento, em relação ao número de casos, foi a seguinte: categorias 0 (1,43%), 1 (7,82%), 2 (80,76%), 3 (8,35%), 4 (1,46%), 5 (0,15%) e 6 (0,03%). Verificou-se taxa de detecção para câncer mamário de 4,8 casos para cada 1.000 exames realizados. O total de carcinoma ductal in situ foi 22,8%. Foram encontrados valores preditivos positivos para as categorias 3, 4 e 5 de 1,3%, 41,3% e 100%, respectivamente. A sensibilidade do método aferida foi 97,1% e a especificidade, 97,4%. Conclusão A auditoria interna completa do serviço de mamografia retrata a qualidade do serviço, e com isso contribui para a detecção precoce e diminuição da mortalidade relacionada ao câncer mamário. .
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Objective To evaluate the BI-RADS as a predictive factor of suspicion for malignancy in breast lesions by correlating radiological with histological results and calculating the positive predictive value for categories 3, 4 and 5 in a breast cancer reference center in the city of São Paulo. Materials and Methods Retrospective, analytical and cross-sectional study including 725 patients with mammographic and/or sonographic findings classified as BI-RADS categories 3, 4 and 5 who were referred to the authors' institution to undergo percutaneous biopsy. The tests results were reviewed and the positive predictive value was calculated by means of a specific mathematical equation. Results Positive predictive values found for categories 3, 4 and 5 were respectively the following: 0.74%, 33.08% and 92.95%, for cases submitted to ultrasound-guided biopsy, and 0.00%, 14.90% and 100% for cases submitted to stereotactic biopsy. Conclusion The present study demonstrated high suspicion for malignancy in lesions classified as category 5 and low risk for category 3. As regards category 4, the need for systematic biopsies was observed. .
Objetivo Avaliar o sistema BI-RADS como fator preditivo de suspeição para malignidade em lesões mamárias, correlacionando os achados radiológicos e os resultados histológicos por meio do cálculo do valor preditivo positivo das categorias 3, 4 e 5 em serviço de referência em diagnóstico e tratamento de câncer de mama da cidade de São Paulo. Materiais e Métodos Estudo retrospectivo, analítico e transversal contendo casuística de 725 pacientes com achados mamográficos e/ou ultrassonográficos classificados nas classes 3, 4 e 5 do BI-RADS e que foram encaminhadas para realização de biópsia percutânea. Os exames foram revisados e o cálculo do valor preditivo positivo foi feito utilizando-se equação matemática específica. Resultados Os valores preditivos positivos encontrados das categorias 3, 4 e 5 foram 0,74%, 33,08% e 92,95%, respectivamente, para os casos de biópsias orientadas pelo ultrassom, e 0,00%, 14,90% e 100% para os casos orientados por estereotaxia. Conclusão Este estudo demonstrou alta suspeição para malignidade em lesões classificadas na categoria 5 e diminuto risco para a categoria 3. Quanto à categoria 4, ficou constatada a necessidade de biópsias sistemáticas. .
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Ao longo dos últimos anos, drásticas mudanças ocorreram na incidência, no diagnóstico, na classificação,na natureza e no tratamento das doenças mamárias, particularmente em relação aoscarcinomas in situ, e ao emprego de biópsias percutâneas para avaliação das lesões detectadas àmamografia. A maioria dos consensos e das recomendações, quando o diagnóstico de carcinomaductal in situ (CDIS) é feito pela biópsia por agulha grossa, é prosseguir a investigação com a biópsiaexcisional. Entretanto, o significado da neoplasia lobular diagnosticada por meio de biópsiaestereotáxica representa novo campo de debate.
Dramatic changes occurred in the incidence, diagnosis, classification, nature, and management of thebreast diseases during the last years, particularly between the in situ carcinomas and the role of percutaneousbiopsies used for the mammographic lesions. The vast majority of consensus recommends excisionalbiopsy following a result of ductal in situ carcinoma obtained by core biopsies. But there are a lot of questionswhen lobular carcinoma is encountered after stereotaxis biopsies.
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Humans , Female , Biopsy, Needle/classification , Biopsy, Needle/methods , Carcinoma, Ductal, Breast/diagnosis , Carcinoma in Situ/diagnosis , Breast Neoplasms/diagnosis , BiopsyABSTRACT
We present a case of symptomatic syringomyelia involving the spinal cord, which was managed by repeated CT-guided percutaneous aspiration, achieving significant decompression by imaging and clinical improvement of lower extremity numbness and weakness. Symptomatic syringomyelia, however, recurred on follow-up, and percutaneous aspiration was repeated four times at the average duration of 22 months. In no aspiration procedure did the patient experienced periprocedural complication. CT-guided percutaneous drainage of syringomyelia is a safe technique, and can be repeated as therapeutic alternative to surgery with temporary improvement of the symptom.
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Humans , Decompression , Drainage , Follow-Up Studies , Hypesthesia , Lower Extremity , Spinal Cord , SyringomyeliaABSTRACT
Percutaneous interventional procedures under image guidance, such as biopsy, ethanol injection therapy, and radiofrequency ablation play important roles in the management of hepatocellular carcinomas. Although uncommon, the procedures may result in tumor implantation along the needle tract, which is a major delayed complication. Implanted tumors usually appear as one or a few, round or oval-shaped, enhancing nodules along the needle tract on CT, from the intraperitoneum through the intercostal or abdominal muscles to the subcutaneous or cutaneous tissues. Radiologists should understand the mechanisms and risk factors of needle tract implantation, minimize this complication, and also pay attention to the presence of implanted tumors along the needle tract during follow-up.
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Biopsy, Needle/adverse effects , Carcinoma, Hepatocellular , Catheter Ablation/adverse effects , Ethanol/administration & dosage , Injections , Liver Neoplasms/pathology , Neoplasm Seeding , Tomography, X-Ray ComputedABSTRACT
Objective To evaluate the clinical application and safety of CT-guided pereutaneous transthoracic biopsy in the diagnosis of mediastinal masses.Methods Thirty three cases were undertaken CT- guided percutaneous transthoraeie biopsy with automatic biopsy gun and then the sampling specimens were undergone histological examination.The accuracy of puncture,diagnostic correctness and complications were analyzed.Results The operations were performed successfully in all 33 cases(100%),the definite pathologic diagnosis were made in 28 out of 33 cases(85%)and no complications occurred.Conclusion As for midiastinal masses,CT-guided percutaneous transthoracic biopsy is a feasible,successful,efficient interventional diagnostic method with high accuracy in localization,puncture,diagnosis and few complications, which should he recommended in clinical use more widely.(J Intervent Radiol,2007,16:852-854)
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Objective To evaluate the clinical value of CT-guided percutaneous biopsy for bone lesions.Methods Forty-Eight patients with different sited bone lesions had received the procedure of CT-guided percutaneous biopsy from July 2003 to January 2005,including 34 cases only with complete clinical records.The procedure was carried out with patient lied on CT table and followed by localization scanning to demonstrate the best sites for puncture and biopsy route.11-14 G bone puncture needle or 18 G trigger type biopsy needle was undertaken to penetrate into the lesion for obtaining specimens under local anesthesia and CT monitoring and in turn for fixation with 10% formalin to have pathologic examination.Results The whole procedure finished within 20-40 minutes with adequate samples obtained for pathologic examination of all cases.Confirmed diagnosis was made in 30 cases with an accuracy of 91.2% and no correlative complications were found.Conclusions The CT-guided percutaneous biopsy is safe and efficient for diagnosis of bone lesions,deserving to be extensively used.(J Intervent Radiol,2006,15: 603-606)
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PURPOSE: To compare the diagnostic accuracy and complication rates of fluoroscopy-guided percutaneous transthoracic fine needle aspiration biopsy (FNAB) and core biopsy (CB). MATERIALS AND METHODS: Ninety-one fluoroscopy-guided lung biopsies were performed in 86 patients using a 22-gauge fine needle (n=52) or a 21-gauge automated cutting needle (n=39). The size of pulmonary lesions were 1-9 cm. Histologic diagnosis rates and complications rates of the two groups were compared. RESULTS: The overall sensitivity of FNAB was 98% (51/52) which was higher than that of CB 89.7% (35/39) (p=0.160, Fisher? exact test). For the diagnosis of malignancy, sensitivities of FNAB and CB were 97.2% (35/36) and 89.7% (26/29), respectively (p= 0.316). For the diagnosis of benignancy, sensitivities of FNAB and CB were 100% (16/16) and 90% (9/10), respectively (p=0.384). The specific histologic diagnosis rate of CB was 80% (8/10) in benignancy, which was higher than that of FNAB 56% (9/16) (p=0.398). The pneumothorax rates were 7.7% (4/52) for FNAB and 15.4% (6/39) for CB (p=0.316). CONCLUSION: Although not statistically significant, a higher overall sensitivity was found in fluoroscopy-guided FNAB in the diagnosis of both malignancy and benignancy, and FNAB also achieved lower complication rates. More specific histologic diagnoses were obtained with CB.
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Humans , Biopsy , Biopsy, Fine-Needle , Diagnosis , Lung , Lung Neoplasms , Needles , PneumothoraxABSTRACT
Paraganglioma is an extraadrenal pheochromocytoma originating from chromaffin ceIls distributed in sympathetic nervous systems. This tumor often can produce catecholamines and induce sustained or paroxysmal hypertension, with or without the typical symptams of headache, palpitation and sweating. Paraganglioma without the usual clinical manifestations is not easy to suspect and diagnose. Herein, we report a case of atypical retroperitoneal paraganglioma which was thought to be the pancreas tail mass and result in a paroxysmal adrenergic crisis and fatal dilated cardiomyopathy after the sonographically guided percutaneous biopsy. This rare case warns against the usual practice of percutaneous biopsy for the preoperative diagnosis of intraabdominal or retmperitoneal tumors.
Subject(s)
Biopsy , Cardiomyopathy, Dilated , Catecholamines , Diagnosis , Headache , Hypertension , Pancreas , Paraganglioma , Pheochromocytoma , Sweat , Sweating , Sympathetic Nervous SystemABSTRACT
Objective To improve both the technique and the clinical application of CT-guided percutaneous aspiration biopsy for sacral lesions. Methods CT-guided percutaneous aspiration biopsy was performed in 21 patients with sacral lesions. By using Ackerman drilling needle, trigger type biopsy needle or Chiba needle, both bony and non-bony specimens were collected. Results The procedure was successfully done in all patients and the pathologic diagnosis was obtained in 95.2%. Failure occurred in one case as only necrotic tissue and blood clot were collected in biopsy. Conclusion As a simple, safe and reliable technique, CT-guided percutaneous aspiration biopsy is very helpful in making correct preoperative diagnosis, providing important preoperative reference for the surgeons.
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Objective To evaluate the clinical application of MRI guided percutaneous biopsy for the lesions of infratemporal space.Methods An open design 0.2T MRI set was used for MRI guided percutaneous biopsy in seven patients with the masses of infratemporal space. Results Of this series, the accuracy of needle puncture was 100% with diagrostic accuracy of 85.7% and no complications.Conclusions MRI guided percutaneous biopsy is helpful in the diagnosis for the lesions of infratemproal space.
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Objective To compare the clinical utility of CT-guided percutaneous biopsies for bone destruction. Methods The retrospective analysis of pathologic outcomes of 89 cases guided by X-ray and MRI, were obtained by needle aspiration (n=13) of 18-20G tru-cut biopsy needles (n=22) and 11-13G Ostycut biopsy needles (n=40). Results Seventy five (84.3%) patients with percutaneous biopsy outcome with concordant results from specimens subsequently obtained at surgery, 14 patients (15.7%) showed pseudo-negative results but no pseudo-positive cases. No obvious differences in pathological results were obtained among these three methods. Conclusions ① CT-guided percutaneous biopsy is effective in the evaluation of skeletal destructive lesions; ② Appropriate selection of percutaneous biopsy method for different kinds of lesion could raise the diagnostie accurracy.