Role of the ultrasound- guided core needle biopsy in the assessment of cervical lymphadenopathy

Abstract

Objective: To evaluate the effectiveness and associated factors of ultrasound-guided core needle biopsy (US-CNB).

Subjects and Methods: A cross-sectional descriptive study was conducted on 201 patients with suspected cervical lymphadenopathy, having a transverse diameter ≥ 5mm, who underwent US-CNB at the Diagnostic Ultrasound Department of 108 Military Central Hospital from January 2022 to September 2023.

Results: Among 201 biopsied nodes, metastatic lymph nodes were the majority (52.2%), followed by lymphoma (15.9%) and benign lymph nodes (31.9%). Adequate diagnostic and histopathological subtyping specimens constituted the majority with 126 cases (62.6%), specimens requiring additional tests for diagnosis were 51 cases (25.4%), specimens deemed inadequate were 7 cases (3.5%), and equivocal specimens requiring surgical excision were 17 cases (8.5%). The sensitivity, specificity, and accuracy of cervical lymphadenopathy US-CNB were 93.4%, 100%, and 95.5%, respectively. Among 32 cases of lymphomas, 21 were diagnosed through US-CNB, and the remaining 11 cases required surgery, resulting in an overall accuracy of 65.6% for diagnosing lymphoma. Inadequate lymphadenopathy specimens were more common in the lymphoma group compared to metastatic and benign lymph nodes, and this difference was statistically significant with p < 0.05. Differences in transverse diameter, necrotic features, and needle size between the two groups were not statistically significant. No complications were encountered post-US-CNB. Conclusion: US-CNB is a safe and effective method for diagnosing cervical lymphadenopathy with high accuracy and minimal invasiveness.