Closed biopsy of the spine using a stereotactic biopsy forceps

Summary A new technique for closed biopsy of the spine is presented. Using a stereotactic biopsy forceps, which is advanced to the lesion through a protective puncture cannula, sufficient samples from different sites of the lesion can be obtained. Biopsy was performed in seven patients harbouring osteolytic and osteoplastic lesions of the cervical (3 cases), thoracic (3 cases) and lumbar spine (1 case). Histological diagnosis was possible in five patients. In all of them, metastatic disease was found. In our opinion, using this device closed biopsy of the spine is a simple and efficient method for obtaining sufficient material at different levels of the spine and at different sites within a lesion. We recommend its use when the therapeutic consequences-surgical tumour removal with stabilization, stabilization alone or radiation therapy-is contingent on the histopathological diagnosis.     

Results of the 5 region prostate biopsy method: the repeat biopsy population

PURPOSE: The decision to repeat prostate biopsy in a patient in whom the first biopsy did not detect prostate cancer poses a challenge to urologists. Many published series show a low yield on repeat biopsy using standard techniques. We reviewed our data on the 5 region prostate biopsy method to evaluate its yield in the repeat biopsy population. MATERIALS AND METHODS: A total of 125 repeat transrectal ultrasound guided prostate needle biopsy sessions were done in 110 patients for standard indications using the 5 region method. Pathological findings were reviewed and the yield of the additional regions was analyzed. RESULTS: Patients were categorized with respect to the initial biopsy technique. In those who underwent 1 and more than 1 previous sextant biopsy the relative increase in yield of the 5 region technique over the standard sextant technique was 31% and 33%, respectively. In the cohort that underwent previous 5 region biopsy the relative increase in yield of the 5 region technique over the standard sextant technique was 38%. CONCLUSIONS: In the setting of repeat biopsy the 5 region method results in an increased yield over the sextant method. It is true in patients who have previously undergone biopsies with the sextant or 5 region technique.     

Outcomes of small renal mass needle core biopsy, nondiagnostic percutaneous biopsy, and the role of repeat biopsy

Background

Percutaneous needle core biopsy has become established in the management of small renal masses ≤4 cm (SRMs). Recent series have reported success rates of ≥80%. Nondiagnostic results continue to be problematic.

Objective

To determine the results of SRM biopsy and the outcomes of nondiagnostic biopsy and repeat biopsy.

Design, setting, and participants

Patients undergoing renal tumor biopsy (RTB) for suspected renal cell carcinoma (RCC) were included in a prospectively maintained database.

Measurements

The database was analyzed retrospectively to determine the pathology and outcomes of SRM biopsy. Outcomes of patients with nondiagnostic biopsy were determined. Patients undergoing repeat biopsy were identified and their outcomes analyzed.

Results and limitations

Three hundred forty-five biopsies were performed (mean diameter: 2.5 cm). Biopsy was diagnostic in 278 cases (80.6%) and nondiagnostic in 67 cases (19.4%). Among diagnostic biopsies, 221 (79.4%) were malignant, 94.1% of which were RCC. Histologic subtyping and grading of RCC was possible in 88.0% and 63.5% of cases, respectively. Repeat biopsy was performed in 12 of the 67 nondiagnostic cases, and a diagnosis was possible in 10 (83.3%). Eight lesions were malignant and two were oncocytic neoplasms. Pathology was available for 15 masses after initial nondiagnostic biopsy; 11 (73%) were malignant. Larger tumor size and a solid nature on imaging predicted a successful biopsy on multivariate analysis. Grade 1 complications were experienced in 10.1% of cases, with no major bleeding and no seeding of the biopsy tract. There was one grade 3a complication (0.3%).This is a retrospective study and some data are unavailable on factors that may affect biopsy success rates. Repeat biopsy was not standard practice prior to this analysis.

Conclusions

RTB can be performed safely and accurately in the investigation of renal masses ≤4 cm. A nondiagnostic biopsy should not be considered a surrogate for the absence of malignancy. Repeat biopsy can be performed with similar accuracy, providing a diagnosis for most patients.     

Aspiration biopsy of the prostate

Summary Fine needle aspiration biopsy of the prostate was performed on 158 patients and compared to histological material. All patients had Tru-cut needle biopsies; 83 had subsequent prostatectomies, 82 transurethral, 1 suprapubic, and 1 patient had a cystoprostatectomy. Fine needle aspiration biopsies had a sensitivity of 90% and a specificity of 100%. Core biopsies were compared to prostatectomy histologies with a sensitivity of 82% and a specificity of 100%. Fine needle aspiration biopsy is an accurate and well-tolerated method of diagnosing carcinoma of the prostate gland.     

Comparison of the Tru-cut biopsy needle with the Abrams punch for pleural biopsy.

In a prospective study pleural biopsy specimens obtained with a Tru-cut needle were compared with those obtained with an Abrams pleural biopsy punch from 36 patients in Zimbabwe judged to have an effusion of at least 1.5 litres; one patient had two biopsies. Both instruments were used on each patient, the Abrams punch being followed by the Tru-cut needle. There were no serious complications. The diagnoses determined by biopsy were: tuberculosis (11); carcinoma (12); chronic inflammation (9); and pleural fibrosis (4); one biopsy showed nothing abnormal. In 23 (62%) patients both biopsy needles produced adequate diagnostic material; in eight the Tru-cut needle alone produced diagnostic material and in six the Abrams punch alone. Thus diagnostic material was obtained in 31 patients from the Tru-cut needle and in 29 from the Abrams punch. The Tru-cut needle was useful and safe for pleural biopsy in this series and appeared to be particularly useful when the pleura was thickened.     

Transrectal aspiration biopsy versus transperineal core biopsy for the diagnosis of carcinoma of the prostate

Transrectal aspiration and transperineal core biopsies were performed on 38 patients with suspicious prostatic examinations. The false negative rate was 14 per cent by the core method but no cancer was missed by the aspiration technique. There was insufficient material for diagnosis in 14 per cent of the biopsies obtained by the core technique but in only 3 per cent with the aspiration biopsy method. Malignant cells were confirmed by cytology in 1 patient who had had 2 normal core biopsies. The cytological grade was only moderately consistent with the Gleason sum. No complications developed after either procedure. Transrectal aspiration biopsy offers several advantages over conventional biopsy methods and should be used regularly to diagnose abnormalities of the prostate.     

Technic and results of fine needle biopsy, cylinder biopsy and surgical biopsy

Mammography-screening contributes new diagnostic problems. In spite of sophisticated diagnostic procedures, surgical excision is the only way to diagnosis in microcalcifications. Triple-diagnosis may lead to the correct diagnosis of a carcinoma, but in most cases a tumor has to be excised if present. Specialists in senology tend to expensive and complicated diagnosis.     

经会阴前列腺穿刺与经直肠前列腺穿刺活检在前列腺癌诊断的初探

目的 对比经会阴与经直肠前列腺穿刺活检在前列腺癌诊断中的阳性率及并发症。方法 回顾分析2017年1月到2019年12月行前列腺穿刺活检的病例,经直肠组187例,经会阴组68例。结果 经直肠组阳性穿刺率为34.7%,经会阴组阳性穿刺率为29.4%,两组无统计学差异（P>0.05）。穿刺后经直肠组和经会阴组的血尿发生率分别为40.1%、42.6%,尿潴留发生率分别为6.9%、7.3%,直肠出血发生率分别为1.1%、0%,差别无统计学意义（P>0.05）。穿刺后经直肠组和经会阴组的会阴肿胀的发生率分别为2.6%、13.2%,两组有统计学差异（P<0.05）。结论 超声引导下经直肠、经会阴前列腺穿刺活检均为前列腺癌诊断的有效方法。两者穿刺阳性率无明显差异,但并发症各有特点。     

Percutaneous renal biopsy using Biopty biopsy instrument and Biopty biopsy needle

We assessed the clinical usefulness of Biopty biopsy instrument & Biopty biopsy needle in percutaneous renal biopsy (PRB) compared with Tru-cut disposable needle and Vim-Silvermann needle. Sixty cases, each consisting 20 cases, were performed PRB by 3 different needles. There was no significant differences between Biopt y-cut needle and Tru-cut needle in the length of renal biopsy tissue and number of glomeruli obtained. The frequency of clinical complications such as fever, flank pain and decrease in Ht greater than 2% was lower in Biopty needle group after PRB. The frequency of middle and large size of hematoma was also lower in Biopty needle group after PRB. We could also obtain specimen from transplanted kidney without complications except small hematoma. From three results, Biopty biopsy needle is a useful tool in performing PRB.