American Journal of Roentgenology, Vol 172, 933-937, Copyright © 1999 by American Roentgen Ray Society

ARTICLES

Imaging-guided percutaneous biopsy of focal splenic lesions: update on safety and effectiveness

MT Keogan, KS Freed, EK Paulson, RC Nelson and LG Dodd
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.

OBJECTIVE: The purpose of this study is to determine the safety and effectiveness of percutaneous imaging-guided biopsy in the diagnosis of focal splenic lesions. MATERIALS AND METHODS: From May 1995 to November 1997, 20 imaging-guided biopsies of focal splenic lesions were performed in 18 patients, including seven patients with a prior diagnosis of extrasplenic malignancy (breast cancer, n = 3; lymphoma, n = 2; ovarian cancer, n = 1; and osteogenic sarcoma, n = 1), three immunosuppressed patients (cause of immunosuppression: AIDS, n = 1; liver transplantation, n = 1; and bone marrow transplantation, n = 1), two patients with anemia, one patient with a recent history of IV drug abuse, and five patients with incidentally discovered splenic lesions. Biopsies were performed with an 18-gauge (n = 1), a 20-gauge (n = 8), or a 22-gauge (n = 14) self-aspirating needle or an 18-gauge cutting needle (n = 1). Biopsies were considered successful if a specific diagnosis of benign or malignant disease was made. RESULTS: A specific diagnosis was made in 16 (88.9%) of 18 patients, and no complications occurred. Malignancy was diagnosed in six patients including three patients with lymphoma. Benign conditions were diagnosed in 10 patients: a cyst in two patients; hamartoma in one; lipogranuloma in one; infarct in one; and infection in four, including one case each of Candida albicans, Pneumocystis carinii, Mycobacterium tuberculosis, and mixed flora. The tenth benign diagnosis was a pseudotumor of the spleen related to a bulbous tail of the pancreas that was inseparable from the splenic hilum. Biopsy did not establish a diagnosis in one patient with lymphoma and in one patient with presumed splenic candidiasis. A mean of 1.5 needle passes was made per biopsy. CONCLUSION: Imaging-guided splenic biopsy is a safe technique that provides a specific diagnosis in most patients with focal splenic lesions.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. H. Choi, J. M. Lee, K. H. Lee, S. H. Kim, J. Y. Lee, J. K. Han, and B. I. Choi Postbiopsy Splenic Bleeding in a Dog Model: Comparison of Cauterization, Embolization, and Plugging of the Needle Tract Am. J. Roentgenol., October 1, 2005; 185(4): 878 - 884. [Abstract] [Full Text] [PDF]

				W. M. Thompson, A. D. Levy, N. S. Aguilera, L. Gorospe, and R. M. Abbott Angiosarcoma of the Spleen: Imaging Characteristics in 12 Patients Radiology, April 1, 2005; 235(1): 106 - 115. [Abstract] [Full Text] [PDF]

				U. Metser, E. Miller, A. Kessler, H. Lerman, G. Lievshitz, R. Oren, and E. Even-Sapir Solid Splenic Masses: Evaluation with 18F-FDG PET/CT J. Nucl. Med., January 1, 2005; 46(1): 52 - 59. [Abstract] [Full Text] [PDF]

				A. D. Levy, R. M. Abbott, and S. L. Abbondanzo Littoral Cell Angioma of the Spleen: CT Features with Clinicopathologic Comparison Radiology, February 1, 2004; 230(2): 485 - 490. [Abstract] [Full Text] [PDF]

				S. Lieberman, E. Libson, B. Maly, P. Lebensart, D. Ben-Yehuda, and A. I. Bloom Imaging-Guided Percutaneous Splenic Biopsy Using a 20- or 22-Gauge Cutting-Edge Core Biopsy Needle for the Diagnosis of Malignant Lymphoma Am. J. Roentgenol., October 1, 2003; 181(4): 1025 - 1027. [Abstract] [Full Text] [PDF]

				B. C. Lucey, G. W. Boland, M. M. Maher, P. F. Hahn, D. A. Gervais, and P. R. Mueller Percutaneous Nonvascular Splenic Intervention: A 10-Year Review Am. J. Roentgenol., December 1, 2002; 179(6): 1591 - 1596. [Abstract] [Full Text] [PDF]