Accuracy of percutaneous ultrasound-guided needle biopsy of abdominal lymph nodes for the diagnosis of malignant disease.

Abstract

The differential diagnosis of suspected neoplastic disease involving deep lymph nodes remains challenging, particularly in the abdomen, where biopsies are technically more complex and associated with higher procedural risks. The present retrospective single-center study aimed to evaluate the feasibility, safety and diagnostic accuracy of ultrasound-guided needle biopsy in patients with neoplastic disease of deep abdominal lymph nodes. A total of 77 abdominal lymph node biopsies were analyzed. Among them, 15 (19.5%) were non-diagnostic. Of the remaining 62 diagnostic biopsies, 40 (64.5%) were lymphomas, 17 (27.4%) were solid tumors, and 5 (8.1%) were non-neoplastic conditions. Among the 57 biopsies positive for neoplastic disease, 32 of 40 (80.0%) lymphomas and six of 17 (35.3%) solid tumors represented new diagnoses, while the remaining cases were histologically confirmed. No procedure-related adverse events were observed. The sensitivity, specificity, positive predictive value and negative predictive value were 100, 83.3, 98.2 and 100%, respectively. The overall diagnostic yield was 80.5%, and the diagnostic accuracy reached 98.4%. US-NB could represent an accurate and reliable diagnostic tool for evaluating suspected neoplastic disease of deep abdominal lymph nodes, both at initial diagnosis and at relapse, offering a favorable safety profile and high diagnostic performance.