Application of ultrasound-guided core biopsy to minimize the non-diagnostic results and the requirement of diagnostic surgery in extrapulmonary tuberculosis of the head and neck
- 273 Downloads
Head and neck extrapulmonary tuberculosis (ETB) presenting as lymphadenopathy poses a great threat by potentially increasing the deterioration of clinical outcomes. Tissue sampling for diagnostic confirmation of ETB is the only invasive procedure during the entire clinical course. It is, therefore, necessary to establish ETB sampling methods with accuracy and minimal invasiveness.
From 2009 to 2014, consecutive patients suspected of ETB receiving ultrasound-guided core biopsy (USCB), fine needle aspiration (FNA), and open biopsy (OB) were enrolled for comparison.
There were 52 cases in the USCB group, 58 cases in the FNA group, and 78 cases in the OB group. For USCB, FNA, and OB groups, the diagnostic rates were 84.6 %, 8.6 %, and 100 % and the positive rates of acid-fast stain were 28.6 %, 0 %, and 37.5 %, respectively. The diagnostic rates of culture were 9.6 %, 0 %, and 50 %, respectively. For head and neck ETB, USCB procedure is timesaving, without leaving poor-healing wounds, scars, and the need for general anaesthesia and hospitalization.
This study helps to optimize the ETB sampling method in head and neck based on diagnostic accuracy and minimal invasiveness. USCB can serve as the first-line diagnostic tool for ETB by reducing non-diagnostic results and the need for diagnostic surgery.
• USCB shows higher diagnostic accuracy of ETB than FNA (84.6 % vs. 8.6 %).
• USCB diminishes wound complications caused by surgical intervention for ETB.
• USCB avoids general anaesthesia and hospitalization for diagnosing ETB.
• USCB saves time and reduces the medical costs of diagnosing ETB.
KeywordsUltrasound Core biopsy Minimally invasive Extrapulmonary tuberculosis Head and neck
The authors thank the Ministry of Science and Technology, the National Taiwan University, and the National Taiwan University Hospital for their support. The authors also thank the staff of the Department of Integrated Diagnostics & Therapeutics, and the staff of the Eighth Core Lab, Department of Medical Research, the National Taiwan University Hospital for technical support of this study.
The scientific guarantor of this publication is Dr. Tsung-Lin Yang. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. This data has not been published elsewhere. Methodology: retrospective, case–control study, performed at one institution
- 1.World Health Organization (2014) Global tuberculosis report 2014. World Health Organization, GenevaGoogle Scholar
- 8.Abdissa K, Tadesse M, Bezabih M et al (2014) Bacteriological methods as add on tests to fine-needle aspiration cytology in diagnosis of tuberculous lymphadenitis: can they reduce the diagnostic dilemma? BMC Infect Dis 14:3850Google Scholar
- 17.Kim BM, Kim EK, Kim MJ et al (2007) Sonographically guided core needle biopsy of cervical lymphadenopathy in patients without known malignancy. J Ultrasound Med: Off J Am Inst Ultrasound Med 26:585–591Google Scholar
- 22.Chen CN, Lin CY, Ko JY, et al. (2015) Application of ultrasound-guided core biopsy as a novel diagnostic tool for base of tongue cancer: our experiences with ten patients. Clin OtolaryngolGoogle Scholar
- 26.Executive Yuan (2007) Department of Health. Center for Disease Control. Taiwan tuberculosis control report. Taiwan: Centers for Disease Control, Department of Health;p. vGoogle Scholar
- 28.Blaikley JF, Khalid S, Ormerod LP (2011) Management of peripheral lymph node tuberculosis in routine practice: an unselected 10-year cohort. Int J Tuberc Lung Dis : Off J Int Union Tuberc Lung Dis 15:375–378Google Scholar