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333

stain which necessitates

requires numerous

several hours (frequently

for four

completion. to five)

This biopsy

passes to assure adequate tissue sampling. Use of a rapid stain technique (Diff-Quik Stain Set Harleco, American Hospital Supply Corp. , Gibbstown, permits

cytologic

Immediate in the into

confirmation

initial

the

diagnosis

within of the

aspirate

obviates

5-i

0 mm after

presence further,

N. J.)

the biopsy. cells

unnecessary

are

laboratory,

examined

and

with

the

or pathologist then neoplastic cells are

64851,

of malignant

cytology

cedure

one

rapid

or more stain

representative

technique.

calls the result to present in the initial

is terminated;

if not,

additional

slides

The

cytologist

the radiologist. aspirate, the aspirations

formed to insure adequate sampling. More a positive specimen is obtained on the initial

If pro-

are

per-

often than pass.

not,

passes

lesion. Results Our

Technique We

(20

use

a standard

biopsy

technique

described [2-3]. Regardless zation of the biopsy ‘ ‘target’ ultrasound,

CT),

great

geometric Suction

placement is applied with

that

has

been

well

of the method used for locali‘ (e.g. , palpation, fluoroscopy,

care

is taken

to

of the needle a 1 0 ml syringe

insure

inadvertent

aspiration

cells

imen, the

cytology slides.

Received

AJR

personnel

The

January

attend

cytologist

30, 1979;

the

pathologist

accepted

after

,

Department

of Radiology,

Mason

Clinic,

P.O.

Department

of Pathology,

Mason

Clinic,

5eattle,

133:333-334,

August

1979;

are

revision,

2

0361 -803x/79/

Box

or other

of the

procedure

and

over

the

surgically). aspiration sied

Two biopsy

and

prepare acutely

April 900, WA

19, Seattle.

nodes

excised;

1 6 months.

each

the

each case was not masses rarely required in cases

in which

the

number

WA

$00.00:

We

showed

no

98101

Address

reprint

requests

© American

Roentgen

Ray

Society

of needle

recorded. more than primary

1979.

98101.

1 332-0333

last

are

aware

of only

lymph had the

evidence

of

node biopmetas-

tasis.

spec-

then

node biopsies 1 3 pancreatic

of the three cases in which was cytologically equivocal

Unfortunately,

material from interposed structures. To insure proper handling and interpretation

includes 40 lymph 3 suspicious),

one false negative biopsy in this patient group to date (but most of the negative biopsies have not been confirmed

tip within the lesion. while short rotational

of extraneous

to date negative,

biopsies (1 2 true positive, 1 false negative), and 22 biopsies of abdominal masses (21 positive, 1 simple hepatic cyst), performed

accurate

and axial excursions of the needle tip are made within the lesion. Suction is released prior to withdrawal of the needle to avoid

experience positive, 17

to R. Kidd.

passes

required

Nevertheless, abdominal one or two passes, except

tumor

was

unknown;

in those

in

TECHNICAL

334

patients, additional electron microscopy. mine the average is lacking.

Downloaded from www.ajronline.org by 218.65.88.206 on 11/02/15 from IP address 218.65.88.206. Copyright ARRS. For personal use only; all rights reserved

two

However, of our last five lymph positive and in each only one pass

were

other

passes were made to obtain material for Similarly, the data necessary to deternumber of passes for lymph node biopsy

three

biopsies

were

two passes was used. in which the initial two passes

obtained

negative,

we cannot

Finally, passes

tumor

and

were

node biopsies, was made. The

in each

recall

negative

a total

a single

and

case

The

impunity

with

through

which

and

into

neopIstic

masses

less,

one instance

of tumor

fine-needle

a 22 or 23 gauge

the abdominal

aspiration

biopsy

wall is now

seeding

needle

recognized.

tract

neoplasm

passes

occur.

Any

refinement

of the thin

needle

in technique

should

reduce

resulting

after has

in fewer

the possibility

Evander cutaneous

of

the

here pass.

procedure. permits

the

The

rapid

cytodiagnosis

stainof

duct.

A, Ihse I, Lundenquist A, Tylen U, Akerman M: Pencytodiagnosis of carcinoma of the pancreas and Ann

Surg

1 88 : 90-92,

1978

2. Zornoza J, Wallace S, Goldstein HM, Lukeman JM, Jing BS: Transpenitoneal percutaneous lymph node aspiration biopsy. Radiologyil2:11i-115, 1977 3. Gothlin JH: Post-lymphangiognaphic percutaneous fine-needle biopsy of lymph nodes guided by fluoroscopy. Radiology 1 20: 205-207,

been reported [4]. As the number of aspiration biopsies increases, other complications, although rare, will undoubtedly

1.

4.

Neverthe-

in the needle

of a pancreatic

be

viscera

from

August 1979

REFERENCES

bile

may

and intervening

resulting

ing technique described neoplasm with a single

subsequent

cells.

AJR:133,

complications

of

Discussion

passed

NOTES

1976

Ferrucci JT Jr, Wittenberg J, Margolies NM, Carey RW: Malignant seeding of the tract after thin-needle aspiration biopsy. Radiology 130:345-346, 1979 5. McLoughlin MJ, Ho CS, Langer B, McHattie J: Fine-needle aspiration biopsy of malignant lesions in and around pancreas. Cancer4l :2431-2419, 1978 6. Fenrucci JT Jr, Wittenberg J: CT biopsy of abdominal tumors: aids for lesion localization. Radiology 1 29 : 739-743, 1978