Automatic core needle biopsy - A diagnostic option for head and neck masses

Objective: To examine the role of core needle biopsy in the diagnosis of head and neck masses. Design: Prospective observational study. Setting: The otolaryngology-head and neck surgery department outpatient clinic of a large managed care organization. Patients: The study population comprised 40 consecutive patients referred for core needle biopsy of a cervicofacial lesion for which previous fine-needle aspiration biopsy had not provided the diagnosis. Intervention: Manually guided Delta Cut (Boston Scientific, Natick, Massachusetts) core needle biopsy was performed on neck masses larger than 1.5 cm. Main Outcome Measure: Diagnosis was indicated by core needle biopsy results without excisional biopsy. Results: A core needle biopsy specimen sufficient for diagnosis and treatment was obtained from 36 of the 40 patients (90%). In 22 patients, subsequent excisional biopsy or curative surgery was performed after core needle biopsy, and pathologic examination confirmed the diagnosis for 19 of these 22 patients (86%). For 12 of the remaining 14 patients (86%), core needle biopsy was successfully used to diagnose lymphoma. No complications resulted from the core needle biopsy. Conclusions: For lesions that require immunohistochemical staining or that remain undiagnosed after fine-needle aspiration, use of core needle biopsy should be considered before excisional biopsy. Core needle biopsy is a safe, effective, time-efficient, inexpensive procedure that can be an important tool for diagnosing head and neck masses, especially when lymphoma is suspected.