Percutaneous Image-guided Splenic Biopsy in the Oncology Patient: An Audit of 156 Consecutive Cases

Alda Tam, Savitri Krishnamurthy, Edmund P. Pillsbury, Joe E. Ensor, Sanjay Gupta, Ravi Murthy, Kamran Ahrar, Michael J. Wallace, Marshall E. Hicks, David C. Madoff

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Purpose: To assess the safety and diagnostic accuracy of percutaneous image-guided splenic biopsy in patients known to have or suspected of having malignancy. Materials and Methods: Data from all image-guided splenic biopsies performed at a single institution from January 1992 to March 2007 were retrospectively reviewed. One hundred fifty-six splenic biopsies were performed in 147 patients (78 male and 69 female patients; mean age, 54.9 years; age range, 13-81 years). The most common indications for biopsy were suspected recurrent lymphoma (n = 101, 64.7%), suspected metastatic disease (n = 39, 25%), and unknown diagnosis (n = 16, 10.3%). All biopsies were performed with computed tomographic (n = 86), ultrasonographic (n = 68), or fluoroscopic (n = 2) guidance. Most biopsies (91%) were performed with 22-gauge needles, with a mean of 2.8 passes. The mean lesion size was 3.2 cm (range, 0.8-13 cm). Final diagnosis was confirmed with splenectomy (n = 39), histopathologic correlation with concurrent biopsy or surgical specimen (n = 52), or clinical or imaging follow-up ranging from 2 weeks to 14 years (n = 44). Complications were recorded. Results: Sufficient tissue for pathologic analysis was obtained in 144 of the 156 biopsies (diagnostic yield, 92.3%). The overall sensitivity, specificity, and diagnostic accuracy were 83.4%, 87.8%, and 84.7%, respectively. Complications occurred in 26 biopsies (16.7%), with a 1.9% (n = 3) major complication rate and a 14.7% (n = 23) minor complication rate. Splenectomy was necessary in two patients. Conclusions: Splenic biopsy in the evaluation of new or recurrent neoplasm is a minimally invasive procedure with low complication rates and a high diagnostic yield.

Original languageEnglish (US)
Pages (from-to)80-87
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume19
Issue number1
DOIs
StatePublished - Jan 2008

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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