Percutaneous Needle Biopsy is Safe
Source:Keogan MT. Am J Roentgenology 1999;172:933-937.
The evaluation of the patient with a focal splenic lesion is often complicated by the need to obtain tissue for diagnosis. Keogan and colleagues examined the safety and efficacy of percutanously obtained needle biopsy in patients with focal splenic lesions. A total of 20 image-guided biopsies were obtained in 18 patients, seven of whom had a history of malignancy, one had AIDS, two were post-transplantation, and five had lesions discovered incidentally. One patient had a history of parenteral drug use. A mean of 1.5 needle passes were performed per biopsy; most of the aspirates were performed using a 20- or 22-gauge needle, but two required an 18-gauge needle or an 18-gauge cutting needle.
Using this technique, a specific diagnosis was made in 16 of the patients (89%). Six patients were diagnosed with various malignancies, including lymphoma in three. Benign conditions were identified in 10 patients including a cyst in two and, in one patient each, hamartoma, lipogranuloma, infarction, and a pseudotumor due to aberrant pancreatic tissue adherent to spleen. Four (20%) of the patients were found to have a variety of infectious conditions, including focal infection due to Candida, Mycobacterium tuberculosis, Pneumocystis carinii pneumonia, and mixed bacterial organisms. Keogan et al were unsuccessful in establishing the diagnosis using only this technique in 11% of the patients, including one with splenic candidiasis and one with lymphoma. No significant complications were encountered. This small study demonstrates that percutaneous image-guided needle biopsy is a safe method for obtaining tissue diagnosis in patients with focal splenic lesions.
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