Image-guided core needle biopsy in the diagnosis of malignant lymphoma: comparison with surgical excision biopsy.

This study aimed to compare the efficacy and safety of image-guided core needle biopsy (CNB) with those of surgical excision biopsy (SEB) for the diagnosis of lymphoma, and to clarify the indication of CNB in clinical practice. This retrospective study included 263 image-guided CNB cases and 108 SEB cases that were performed at our institution between January 2014 and December 2018. The rate of patients with performance status of grade 1-4 was higher in the CNB group than in the SEB group (43.7% vs. 24.1%, P <  0.01). Waiting time to biopsy and diagnosis was shorter for CNB group than for SEB group (4 days vs. 7 days, 13 days vs. 15 days, P <  0.01). The rate of biopsy at the deep sites was higher in the CNB group than in the SEB group (53.2% vs. 8.3%, P <  0.01). Successful biopsy and complication rates were compared between the 2 groups. There were no significant differences between the CNB and SEB groups in successful biopsy rates (89.0% vs. 93.5%, P =  0.25). The grade 3 complication rate was significantly lower for CNB group than for SEB group (0% vs. 4.6%, P <  0.01), although there was no significant difference in overall complication rates (4.9% vs. 6.5%, respectively, P =  0.61). CNB showed high diagnostic yield comparable to SEB for suspected lymphoma. CNB was especially recommended to the cases with low-PS, lesions in the deep sites, and requiring early pathological diagnosis.

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