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At least 19 recordsLinked to original sources

PubMed2006

[Histopathologic quality of prostate core biopsy specimens: comparison of an MR-compatible biopsy needle and a ferromagnetic biopsy needle used for ultrasound-guided prostate biopsy].

PURPOSE: The histopathologic quality of core biopsy specimens obtained via MRI-guided prostate biopsy using a 16G MR-compatible needle was compared to that of biopsies obtained via ultrasound-guided biopsy using a conventional 18G stainless steel biopsy needle. MATERIAL AND METHODS: A retrospective analysis was performed for a total of 247 transrectal prostate biopsy specimens obtained from 32 patients. A total of 117 tissue cores were obtained from 15 patients (PSA of 10.8 ng/ml, age 64 years) who underwent an MRI-guided prostate biopsy using a 16G (1.7 mm) MR-compatible biopsy needle made of titanium alloy. The remaining 130 tissue cores were obtained from 17 patients (PSA of 6.7 ng/ml, age 68 years) who underwent a transrectal ultrasound-guided prostate biopsy using an 18G (1.3 mm) ferromagnetic stainless steel biopsy needle. The length and width of the histologic sections prepared from the tissue cores were measured to calculate the area. The histopathologic quality of the specimens was assessed microscopically using tissue fragmentation, the presence of crush artifacts, and the overall accessibility as criteria. Each of these features was assigned a score from 0 to 3. All 3 features contributed equally to the overall score which ranged from 0 (no tissue) to 9 (optimal quality). RESULTS: The overall quality scores assigned to the biopsies obtained with a 16G MR-compatible needle and an 18G ferromagnetic needle can be considered to be equivalent to a mean difference between patient related median scores of the specimens of - 0.05 (95 % confidence interval [- 0.46; 0.36]) and a given equivalence limit of 1. The MRI biopsies showed more tissue fragmentation (p = 0.001) but fewer crush artifacts (p = 0.022) while the accessibility did not differ significantly between the two needle types (p = 0.064). There was also no significant difference in the calculated areas of the tissue cores (p = 0.236). According to the different calibers of the biopsy needles, the lengths (p = 0.008) and widths (p = 0.000) of the biopsy specimens differed significantly. CONCLUSIONS: The core biopsy specimens obtained with an MR-compatible 16G titanium alloy biopsy needle are of the same histopathologic quality as specimens obtained with a ferromagnetic 18G stainless steel needle.

Aged↗

PubMed1995

Yield and complications in ultrasound-guided biopsy of abdominal lesions. Comparison of fine-needle aspiration biopsy and 1.2-mm needle core biopsy using an automated biopsy gun.

A series of 458 consecutive ultrasound-guided biopsies in 347 patients-171 fine-needle aspiration biopsies (FNABs) and 287 1.2-mm needle core biopsies (NCBs)-was analysed for diagnostic yield and complications. FNAB was diagnostic in 107 (64%) biopsies of focal lesions with a correct diagnosis of malignancy in 86 of 125 biopsies (69%) and of benign disease in 21 of 43 (49%) biopsies. NCB provided a correct diagnosis in 189 (90%) biopsies for focal lesions, divided into 140 of 159 (88%) correct for malignancy and 49 of 50 (98%) correct for benign disease. In 69 patients examined with both FNAB and NCB on the same occasion, 50 out of 55 malignant lesions were identified with NCB but only 34 with FNAB; all 14 benign lesions were correctly identified by NCB, and only 6 by FNAB. Clinical relevant bleeding complications occurred in 6 out of 458 biopsies (1.3%)-3 out of 287 following NCB (1.0%) and 3 out of 171 following FNAB (1.8%). It is concluded that if FNAB is replaced with 1.2-mm NCB using an automated biopsy gun, the diagnostic accuracy for abdominal lesions increases significantly (p < 0.001), while the complication rate remains the same.

Abdominal Neoplasms↗

PubMed1999

Large needle core biopsy--avoidance of biopsy table bombardment by the biopsy needle in stereotactic guided breast biopsy.

Table bombardment by automated biopsy needle is an occasional technical problem during stereotactic core biopsy of the breast. It is most commonly encountered in small breasts and when lesions are close to the biopsy table. A reference chart is devised for stereotactic core biopsy using an add-on erect stereotactic biopsy table and automated spring-loaded biopsy gun. The chart serves as a reference for pre-biopsy assessment of the feasibility of core biopsy in the vertical approach due to the constraints of lesion depth and breast thickness. It allows easy and quick reference for the required needle length input for the stereotactic system to prevent table bombardment.

Biopsy, Needle↗

PubMed1991

[Study on usefulness of an aspirating biopsy needle (Vacu-Cut) and an automatic biopsy needle (Biopty-Cut) for renal biopsy--comparison with a Tru-Cut biopsy needle].

Our medical team conducted the percutaneous renal biopsy, using an aspirating biopsy needle (Vacu-Cut) in 101 cases, and an automatic biopsy needle (Biopty-Cut) in 82 cases. Thereafter, we examined the usefulness of the two types of needles in comparison with that of Tru-Cut used in 101 cases. The test confirmed that in the cases of Vacu-Cut, 7.6 glomeruli (p less than 0.01), on the average, existed in LM specimen; 9.0 glomeruli (ns), Biopty-Cut, and 10.7 glomeruli, Tru-Cut, respectively. However the incidence of cases containing more than 5 glomeruli was not significant statistically between Vacu-Cut/Biopty-Cut and Tru-Cut. The incidence that each type of needles obtained more than one glomerulus in IF specimen was as follows: 73.3%, Vacu-Cut (p less than 0.05), 81.7%, Biopty-Cut (ns), 87.1%, Tru-Cut, respectively. As for in EM specimen, 61.4%, Vacu-Cut (ns), 67.1%, Biopty-Cut (ns), and 70.3%, Tru-Cut, respectively. As for complications, in the cases of Vacu-Cut and Biopty-Cut, gross hematuria and post-biopsy pain occurred in 6.9 to 9.8% (p less than 0.01- p less than 0.05), whereas in Tru-Cut, they occurred in 20.7 to 24.8%. As for blood pressure lowering (less than 90 mmHg) and anemia (the cases in which blood transfusion was required), 0%, Vacu-Cut and Biopty-Cut, 2 to 3%, Tru-Cut, respectively. As for fever, Vacu-Cut 0%, Vacu-Cut (p less than 0.01), 3.7%, Biopty-Cut (ns), and 7.9%, Tru-Cut, respectively. The above findings lead to conclusion that both Vacu-Cut and Biopty-Cut are useful instruments for renal biopsy.

Adolescent↗

PubMed2004

[Biopsy technique and biopsy schemes for a first series of prostatic biopsies].

OBJECTIVE: To define the modalities of prostatic biopsies in patients with suspected prostate cancer, particularly concerning prevention of complications, the number of biopsies and the biopsy schemes ensuring an optimal cancer detection rate, and recording of prognostic elements, all with an acceptable morbidity, METHOD: Review of the literature. RESULTS: Information before biopsy: A preliminary visit with oral and written information is necessary before any biopsy procedure in order to: describe the modalities of the procedure to improve the patient's cooperation, detect contraindications, guide preparation, explain the risks and elements of surveillance, and describe the management in the case of complications (level of evidence: IV-3). PREPARATION BEFORE BIOPSY: A single dose of prophylactic antibiotic is necessary before the examination. Longer antibiotic prophylaxis is necessary in patients with risk factors for infection (level of evidence: II). A rectal enema is recommended (level of evidence: III). Routine urine bacteriology and blood coagulation tests are unnecessary (level of evidence: II). In patients taking anticoagulants, this treatment must be stopped before the examination (level of evidence: IV-2). BIOPSY TECHNIQUE: Local anaesthesia with 1% lidocaine by ultrasound-guided injection into the periprostatic spaces is recommended to improve tolerability, when the number of biopsies is > 6 (level of evidence: II-2). General anaesthesia may be necessary in a minority of cases, for local anatomical reasons or when preferred by the patient. Prostatic aspiration biopsies should be performed via a transrectal approach with ultrasound guidance, especially in the absence of a palpable lesion (level of evidence: IV-1). The examination must start with digital rectal examination and complete analysis of the echostructure of the prostate to identify suspicious zones that will also be aspirated. Biopsy scheme as a function of stage: In the case of palpable or visible lesion (stage T2 or T3), at least six transrectal ultrasound-guided lateral sextant biopsies including the peripheral glandular zone at the base, in the middle and at the apex of each lobe as well as a biopsy in a suspicious zone are necessary for cancer detection and staging. Each biopsy must be identified or embedded separately to facilitate identification by the pathologist (level of evidence: IV-1). In the absence of palpable or visible lesion (stage T1a, b, c), another 6 sextant midlobar biopsies are recommended (12 biopsy plan). In the case of prostate volume < 40-50 cm3, the two midlobar biopsies of the apex may be eliminated (10 biopsy plan) (level of evidence: III-2). In the case of prostate volume > 40-50 cm3, anterior biopsies (4 additional biopsies, 16 biopsy scheme) including the glandular zone of benign hyperplasia are not routinely recommended (level of evidence: III-2). In stage T4, a biopsy in each lobe is sufficient for histological confirmation of the diagnosis. CONCLUSION: Complementary studies are necessary to validate the 12 biopsy or 16 biopsy plans, especially as a function of prostatic volume, clinical stage and biopsy sequence (first or second series).

Biopsy, Needle↗

PubMed2006

The effect of prior biopsy scheme on prostate cancer detection for repeat biopsy population: results of the 14-core prostate biopsy technique.

OBJECTIVES: To evaluate the diagnostic performance of 14-core repeat biopsy protocol and the impact of prior biopsy scheme on repeat prostate biopsy group. METHODS: 211 patients had repeat biopsy using 14-core protocol consisting of 10-core peripheral zone (classical sextant+4 lateral peripheral cores) and 4-core transitional zone (TZ) biopsies. The diagnostic yield was determined both in patients who had previously undergone sextant or 10-core biopsy protocol. RESULTS: Overall cancer detection rate was 25.6%. 14-core biopsy technique detected cancer in 36.1 and 18.7% of the patients who had a previous sextant biopsy and 10-core biopsy protocol, respectively (P = 0.005). Patients with and without high-grade prostatic intraepithelial neoplasia (HGPIN) in the previous sextant biopsy had 56.5 and 28.3% cancer detection rates on the subsequent extended biopsy, respectively (P = 0.017) Patients who had previous 10-core biopsy with and without HGPIN revealed 22.9 and 17.2% cancer detection rates, respectively (P = 0.465) Additional four lateral peripheral cores detected 33% (3/30) and 17% (4/24) of cancers in patients with previous sextant and 10-core biopsy, respectively. 3.7% of the patients had tumor only in the TZ and none of them had prior extended biopsy. CONCLUSIONS: The yield of extended 14-core repeat biopsy protocol was higher in patients with previous negative sextant biopsy compared to the patients with previous negative 10-core biopsy. HGPIN history found on previous sextant biopsy was a strong cancer predictor on repeat biopsy; same was not true for the patients with previous 10-core biopsy. The yield of lateral peripheral cores and TZ biopsies were lower in patients with prior negative extended biopsy.

Aged↗

PubMed2005

Experience of stereotactic breast biopsy using the vacuum-assisted core needle biopsy device and the advanced breast biopsy instrumentation system in Hong Kong women.

BACKGROUND: Stereotactic breast biopsy of non-palpable lesions using the vacuum-assisted core needle biopsy (CNB) device and the large core excision biopsy system is a reliable biopsy method when compared with open biopsy. Its use in Western countries is well accepted. This study aimed to assess the feasibility and results of using these systems to perform stereotactic biopsy in Asian women. METHODS: A total of 114 patients with non-palpable mammographic lesions underwent stereotactic breast biopsy using the vacuum-assisted CNB device and the large core excision biopsy system between November 1999 and December 2002. The indications for biopsy were mammographic abnormalities considered indeterminate or suspicious that were not palpable or visible on ultrasound. The methods adopted for biopsy in Asian women were reviewed and the results including the final pathology, complications, scarring and acceptance by patients were recorded. RESULTS: Stereotactic breast biopsy was performed using the vacuum-assisted CNB device in 107 patients and the large core excision biopsy system in seven patients. Of those who underwent biopsy using the vacuum-assisted CNB device, 15 (14%) had moderate to severe bleeding during the procedure and seven (6.5%) had severe bruising afterwards. Carcinoma was detected in 31 of the 114 patients (27.2%). CONCLUSION: Although Asian women in general have smaller and denser breasts than their Western counterparts, stereotactic breast biopsy using the vacuum-assisted CNB device and the large core excision biopsy system was feasible with modification of the individual steps during the procedure. Our results are comparable with those published previously and the procedure was well accepted by patients.

Biopsy↗

PubMed2004

A prospective randomized comparison of extensive prostate biopsy to standard biopsy with assessment of diagnostic yield, biopsy pain and morbidity.

In a prospective randomized study, we compare standard prostate biopsy to extensive biopsy utilizing intravenous conscious sedation (IVCS). Initial biopsy patients (n=197) were randomized to either standard biopsy using intrarectal lidocaine gel (6-12 biopsies, mean 10.1) or extensive biopsy (24 biopsies) using IVCS. Cancer detection and urinary symptoms were no different between groups. However, biopsy pain was rated significantly lower and satisfaction significantly higher in the extensive biopsy group. Temporary urinary retention occurred in 4% of the extensive biopsy group. Extended biopsy with 24 samples does not improve cancer detection compared to standard biopsy when 10 cores are obtained. Extensive biopsy is very well tolerated and associated with less pain and more satisfaction than standard biopsy.

Adult↗

PubMedDate not supplied

Diagnosis of lymphoma by image-guided needle biopsies: fine needle aspiration biopsy, core biopsy or both?

OBJECTIVE: To determine whether or not concurrent core biopsy adds to results obtained from image-guided fine needle aspiration biopsy (FNAB) in cases of lymphoma. STUDY DESIGN: Twenty-eight FNABs of lymphomas with adjuvant flow cytometry (FC) and concurrent core biopsy were evaluated retrospectively. In each case, completeness of diagnosis by FNAB, including phenotyping and grading, where appropriate, was reviewed. The contribution of core biopsy to the diagnosis in cases where FNAB did not render a complete diagnosis was assessed. Prognostic information not available from the FNAB but obtained from the core biopsy was also evaluated. RESULTS: FNAB with adjuvant FC gave a complete diagnosis, including phenotype and grade, where applicable, in 23 of 28 cases (82%). Core biopsy added to the diagnosis in 3 cases. In 1 case, large B-cell lymphoma was diagnosed on core biopsy when FNAB was unsatisfactory. In the other 2 cases, grade of follicle center cell lymphoma was higher on core biopsy than on FNAB. The addition of the information obtained by core biopsy to that obtained by FNAB raised the diagnostic accuracy to 93%. Core biopsy was used to assess nodularity, which could not be determined on FNAB. Core biopsy was also used to assess prognostic markers by immunohistochemistry (Ki-67 and p53); they were not available with FC. This was done in 11 cases when requested by the oncologist. CONCLUSION: FNAB with adjuvant FC is a useful technique for diagnosing and subtyping lymphomas. However, diagnosis and subclassification are often insufficient. Core biopsy material provides opportunity for obtaining additional diagnostic and prognostic information that may not be easily derived from the FNAB. This allows optimal treatment planning in patients for whom excisional biopsy is contraindicated.

Adult↗

PubMed2000

Ultrasound-guided biopsies of abdominal organs with an automatic biopsy system. A retrospective analysis of the quality of biopsies and of hemorrhagic complications.

BACKGROUND: Ultrasound-guided biopsies of abdominal organs are not without risks for the patients; in particular, hemorrhagic complications may occur. Thus, over the last few years, automatic biopsy guns have been developed to facilitate the biopsy process. METHODS: The aim of our retrospective study was to examine the quality of specimens and the complication rate of ultrasound-guided biopsies of abdominal organs carried out in our institution using the automatic Autovac biopsy system during a period of 1.5 years. Of the total number of 321 biopsies, 290 were performed with the 1.2-mm Autovac needle, and in 31 cases the 0.95-mm needle was used. Among the 321 biopsies there were 211 of the liver parenchyma (66%), 47 of a liver tumor (14%), 38 of the pancreas (12%), 15 of the kidney parenchyma (5%), and 10 of a retroperitoneal tumor (3%). RESULTS: In 310 of the 321 biopsies it was possible to obtain sufficient diagnostically usable material for the pathologist (96.6%). In the other 11 cases the material obtained did not enable proper histologic diagnosis (3.4%). Two of these 11 biopsies were carried out with the 0.95-mm needle, and the other 9 with the 1.2-mm needle. Twenty-four hours after the biopsy each patient underwent routine ultrasound examination to exclude a possible bleeding. In eight cases an afterbleeding occurred (total hemorrhagic rate, 2.5%), four times without clinical consequences. The other four bleeding complications were more serious (1.2% of all taps), and all occurred after liver biopsies in patients with a history of liver complaints and abnormal clotting variables. There were no fatalities among our biopsies (mortality rate, 0%). CONCLUSION: The automatic Autovac biopsy system is suitable and relatively safe for obtaining sufficient histopathologic material from intra-abdominal organs.

Adolescent↗

PubMedDate not supplied

Comparison of brush before biopsy, suction cytology, brush after biopsy and endoscopic biopsy in the diagnosis of carcinoma oesophagus.

A study was conducted on 40 patients of carcinoma oesophagus to compare the diagnostic yield of brush biopsy, suction cytology, brush after biopsy and endoscopic biopsy. The positive yield with brush before biopsy was 87.5%, with suction cytology 90%, with brush after biopsy 100% and with endoscopic biopsy 90%. Difference in the yield of brush after biopsy compared to other modalities was statistically insignificant (P > 0.05). However, the quantitative yield of the material was significantly high (P < 0.05) in the brush after biopsy compared to brush before biopsy. Of these three cytological modalities brush after biopsy appears to be the cytological technique of choice to be used as an adjunct to endoscopic biopsy.

Biopsy↗

PubMed2000

Use of advanced breast biopsy instrumentation while performing stereotactic breast biopsies: review of 150 consecutive biopsies.

BACKGROUND: Stereotactic breast biopsies are being performed in the United States with increasing frequency. Advanced breast biopsy instrumentation (ABBI) is a recent addition to the list of available stereotactic breast biopsy devices (eg, fine-needle aspiration, automated needle cores, and vacuum-assisted devices). Indications for the ABBI procedure in the management of patients with nonpalpable mammographic lesions have not been established. STUDY DESIGN: Prospectively collected data on 150 patients biopsied with the ABBI procedure were reviewed. RESULTS: From April 1996 to May 1997, 150 patients with indeterminate or suspicious nonpalpable mammographic lesions were biopsied using the ABBI technique. Complications were minor. One patient (0.6%) required a repeat biopsy because of insufficient tissue and one patient had repeat excision to confirm the diagnosis of atypical ductal hyperplasia. Cancer was diagnosed in 26%. Followup mammograms were obtained in 94% of the patients. Lesions were missed in three patients (2%), none of whom were later found to have cancer. One patient (0.6%) required a repeat ABBI biopsy for postbiopsy architectural distortion. Postprocedure mammographic scarring was otherwise minimal and was noted in only 16% of the patients. Of the 111 patients with benign diagnoses, 67 were seen for clinical followup; 98% had good cosmetic outcomes and were satisfied with the ABBI technique. CONCLUSIONS: The ABBI technique is a safe, reliable stereotactic breast biopsy technique that is well accepted by patients. The sensitivity and specificity of ABBI biopsy for the diagnosis of carcinoma in this series were each 100% for the 142 patients returning for followup. Indications for the technique are similar to those for traditional needle localization excisional breast biopsies.

Adult↗

PubMedDate not supplied

Thyroid biopsies: fine-needle aspiration biopsy versus spring-activated core biopsy needle in 102 patients.

PURPOSE: Use of the single-action spring-activated core biopsy needle was compared with the fine needle aspiration biopsy (FNAB) technique in ultrasound (US)-guided thyroid biopsies. PATIENTS AND METHODS: Results in 102 patients who underwent sonographically guided thyroid biopsies with both fine needles and core biopsy needles were prospectively evaluated. Results from the 21-gauge FNAB (n = 102) were compared with results from 18-gauge (n = 1), 19-gauge (n = 2), 20-gauge (n = 43), or 21-gauge (n = 56) single-action spring-activated core biopsy needles. RESULTS: If the suggestive and diagnostic results were combined, the diagnostic accuracy for the core biopsy needle was 90.2% (92 of 102) and was 80.3% (82 of 102) for FNAB (P = .048). The diagnostic accuracy for the combination of both needles was 97.1% (99 of 102). The complication rate was 0.98% (n = 1). This complication was a minor soft-tissue infection successfully treated with orally administered antibiotics. CONCLUSION: In summary, sonographically guided biopsies of the thyroid performed with single-action core biopsy needles are safe and effective. The results with use of these needles are better than the results of FNAB, but the best results are obtained when both needles are used in the same patient.

Adult↗

PubMed2005

Optimization of prostatic biopsy: a prospective randomized trial comparing the sextant biopsy with a 10-core biopsy. Impact of prostatic region of sampling.

OBJECTIVE: New prostatic biopsy protocols suggest to increase the core numbers to enhance detection. Additional cores are usually sampled from the lateral part of the p-zone. We direct the sextant biopsy to the most lateral part of the p-zone, therefore we investigated if there is a gain by adding 4 median biopsy cores. MATERIAL AND METHODS: The prospective randomized trial (n = 200) compared our modified sextant biopsy to a 10-core strategy with 2 additional median cores on both sides. Directed biopsies to suspicious areas were allowed in both groups. Morbidity was assessed by a self-administered questionnaire. RESULTS: PC detection was 32% for 6 cores and 40% for 10 cores. Four patients were detected only by median biopsies. Using the binomial distribution table the gain of 4% is statistically significant. There was no statistical difference in morbidity, but a trend towards a higher rate of side effects in the 10-core group. CONCLUSIONS: The gain in prostate cancer detection rate by additional median biopsies is low, but statistically significant. There is no difference in morbidity and patient acceptance is high, therefore we favor the 10-core biopsy in our patients.

Biopsy↗

PubMed1992

[CT-guided percutaneous lung biopsy using a cutting needle and an automated biopsy gun. Comparison with lung biopsy using a manual aspiration needle].

Twenty-five percutaneous lung biopsies using a 20-gauge cutting needle and automated biopsy gun (ABG) were performed under CT guidance in 25 patients with thoracic lesions. This procedure was compared with that using a 21-gauge manual aspiration needle in 36 patients (40 examinations, 37 lesions) in terms of success rate, rate of correct diagnosis, mean examination time and rate of complications. Specimens obtained from lung biopsy were graded by a histopathologist according to quality and quantity from 0 to 4 (pathological score). There were no statistically significant differences between the two procedures in terms of success rate, rate of correct diagnosis and rate of complications; only the time required was significantly different. However, sufficient biopsy material and a mean pathological score of G-II 2.8 (that of G-I was 1.9, p less than 0.05) could be obtained by the biopsy procedure using the cutting needle. The above results indicated that aspiration needle biopsy was adequate for lung biopsy, but that a cutting needle and ABG should be used when a good biopsy specimen is needed for tissue diagnosis.

Adolescent↗

PubMed1983

Pleural biopsy. A report of 750 biopsies performed using Abrams's pleural biopsy punch.

We present the results of 750 consecutive pleural biopsies performed with the Abrams pleural biopsy punch to indicate the effectiveness, safety and ease of the procedure. The biopsies were performed by 27 members of our medical staff. Pleural tissue was obtained in 90% of the biopsy specimens taken from patients with pleural effusions and in 79% of those taken in the absence of pleural fluid. These 'dry' biopsies were restricted to those operators with a minimum experience of 50 previous biopsies. Inclusion of tissue other than pleura occurred more frequently in the 'dry' biopsies (16.6%) than in those with pleural fluid (0.8%). There were no complications which required intervention. The problem of 'idiopathic' pleural disease is discussed. We emphasize the biopsy technique and the need for a constant and interested histologist.

Biopsy, Needle↗

PubMed1991

Diagnostic sensitivity of different techniques in the diagnosis of lung tumors with the flexible fiberoptic bronchoscope. Comparison of brush biopsy, imprint cytology of forceps biopsy, and histology of forceps biopsy.

Brush and forceps biopsies were done consecutively in 186 cases of pulmonary neoplasia with a flexible fiberoptic bronchoscope guided by x-ray television fluoroscopy. Imprint and histologic sections were prepared from all forceps biopsy specimens. The three techniques were compared for their diagnostic sensitivity. As a result 84.9% of all imprints, 80.6% of brush biopsy specimens, and 62.9% of histologic sections were positive for malignancy. The sensitivity of brush biopsy specimens was independent of the location and morphology of the tumors, but the sensitivity of forceps biopsy specimens was lower in neoplasms unidentified by bronchoscopy. The sensitivity of the diagnostic accuracy when all three methods were used jointly was 97.3%, and the specificity was 100%. Agreement in the final morphologic tumor type was found in 130 of 150 cases (86.7%) by positive brush biopsy specimens, in 136 of 158 cases (86.1%) by positive imprint cytology, and in 104 of 117 cases (88.9%) by positive histology from forceps biopsy specimens. For routine bronchoscopy, all three methods should be used in combination to obtain the highest diagnostic yield.

Biopsy↗

PubMed1988

Biopsy evaluation of chronic active hepatitis. Peritoneoscopy with directed liver biopsy versus blind percutaneous liver biopsy.

In this prospective study of chronic active liver disease, we compared the assessment of hepatic histology in samples obtained by peritoneoscopy with directed liver biopsy and blind percutaneous liver biopsy in 23 cases (22 patients, one patient studied twice). In blinded fashion, a pathologist assessed all specimens for evidence of cirrhosis and degree of necroinflammatory change. Two clinicians independently reviewed clinical and laboratory findings in both sets of biopsies. Each committed in writing recommendations regarding immunosuppressive therapy, follow-up interval, and rebiopsy date. The final diagnosis differed from that made by percutaneous and directed biopsy in 2 of 23 (9%) and 1 of 23 (4%) cases, respectively. Six cases of cirrhosis were correctly diagnosed by both biopsy methods, but only four of the six cirrhotic cases were diagnosed by gross peritoneoscopic findings. In only 2 of 23 (9%) cases was there disagreement in the degree of necroinflammatory change between the blind and directed biopsies that affected treatment recommendations. We conclude that blind percutaneous biopsy adequately diagnoses and monitors activity in viral chronic hepatitis for treatment purposes.

Adult↗