Diagnosing of parotid gland masses with ultrasonography-guided core-needle biopsy [USCNB]

ABSTRACT

An accurate diagnosis of a parotid gland mass is essential for adequate management. We determined the clinical efficacy of ultrasound-guided core needle biopsy [USCNB] in diagnosing parotid gland masses by using cutting needles of different bores. We reviewed records for 40 benign and 13 malignant parotid lesions. Ultrasound-guided core needle biopsy [USCNB] was performed by using 14-20-gauge needles [mean, 16.6 gauge] with one to five [mean, 2.43] passes and a 15-mm throw or specimen notch. Final diagnoses were established on the basis of surgicopathologic results in 31 cases, and on the basis of histopathologic analysis of biopsy specimens, clinical data, and/or imaging studies in 22, with a follow-up of 12.2-77.5 months [mean, 33.6 months]. Compared with surgicopathology, USCNB had a sensitivity of 83%, a specificity of 100%, and an accuracy of 97% in providing specific tissue diagnoses and in differentiating malignant from benign masses. Its positive and negative predictive values were 100% and 96%, respectively, in diagnosing malignancy. One patient [2%] had a local hematoma without sequela after surgical removal of a Warthin tumor. Core biopsy results were completely concordant with surgical findings in 30 [97%] of 31 cases. USCNB is a safe and efficient diagnostic procedure with an accuracy of 97% in the pathologic diagnosis of parotid masses. It can be performed in an outpatient clinic and enables specific tissue diagnosis to obviate intraoperative frozen biopsy and unnecessary surgery. An 18-gauge needle is sufficient for accurate and specific tissue diagnosis of parotid masses