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Diagnosis of Kikuchi-Fujimoto disease: a comparison between open biopsy and minimally invasive ultrasound-guided core biopsy.

Yu SC, Chen CN, Huang HI, Chen TC, Wang CP, Lou PJ, Ko JY, Hsiao TY, Yang TL - PLoS ONE (2014)

Bottom Line: Similar pathological presentations were found both in the specimens of USCB and OB.Sampling errors were found both in USCB and OB.OB can be applied only in the failed cases of USCB.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, National Taiwan University Hospital, Taiwan.

ABSTRACT
Kikuchi-Fujimoto disease (KFD) is a self-limited disease without any need of surgical treatments. Sampling of tissue is the only invasive procedure during the clinical course. However, the standard sampling procedure with accuracy, minimal invasiveness, and esthetic maintenance has not been established yet. In this study, a retrospective review of clinical utility and pathological presentations of the ultrasound-guided core biopsy (USCB) and the open biopsy (OB) in consecutive KFD patients. From 2010 to 2012, 34 consecutive patients were enrolled. USCB was performed in 11 patients, and OB was done in 26 patients. KFD was confirmed in 82% cases by USCB. Similar pathological presentations were found both in the specimens of USCB and OB. In the three patients who had received both USCB and OB, KFD was confirmed by USCB in one case, while two by OB. Sampling errors were found both in USCB and OB. For diagnosing KFD, USCB can serve as the first-line diagnostic tool. OB can be applied only in the failed cases of USCB.

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Related in: MedlinePlus

Sonographic presentation and USCB of KFD.a. Multiple lymph nodes with heterogeneous echogenicity and well-defined margins. b. Color duplex mode showed central lymphatic hilus in the enlarged nodes. c. A core needle (arrow) was inserted into the lymph nodes for tissue harvest. d. The inner needle (arrow) was pushed forward to expose the notch for harvesting tissue specimens within the lymph nodes.
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pone-0095886-g001: Sonographic presentation and USCB of KFD.a. Multiple lymph nodes with heterogeneous echogenicity and well-defined margins. b. Color duplex mode showed central lymphatic hilus in the enlarged nodes. c. A core needle (arrow) was inserted into the lymph nodes for tissue harvest. d. The inner needle (arrow) was pushed forward to expose the notch for harvesting tissue specimens within the lymph nodes.

Mentions: The patient was placed in a supine position with the neck hyper-extended. Each patient signed informed consents. The neck skin was disinfected and draped in the standard manner of antiseptic procedure. An ultrasound examination was performed with a 12 MHz linear probe (Toshiba Aplio SSA790 diagnostic ultrasound system, Tochigi-ken, Japan). For USCB, sonographic features and the location of targeted lymph nodes were evaluated and recorded. A color-duplex model was used to avoid vascular injury during USCB. After identifying the safest path to the targeted lesions, local anesthesia was applied. An 18-gauge biopsy needle (Temno Evolution Biopsy Devices, Cardinal Health Inc., Dublin, USA) was guided by ultrasound for sampling. After tissue harvesting, the specimen was removed from the needle notch, checked for quality and quantity, and fixed in formalin. One tissue sample was first collected. If the tissue quality and quantity was not good enough in the gross examination, the second shot was performed. Specimens harvested from cervical lesions were sent for pathological diagnosis. After the procedure, oozing from the puncture wound was controlled with pressure for 5 minutes. The patient was observed for 30 minutes. If there were no signs of complications, the patient was then discharged (Fig 1).


Diagnosis of Kikuchi-Fujimoto disease: a comparison between open biopsy and minimally invasive ultrasound-guided core biopsy.

Yu SC, Chen CN, Huang HI, Chen TC, Wang CP, Lou PJ, Ko JY, Hsiao TY, Yang TL - PLoS ONE (2014)

Sonographic presentation and USCB of KFD.a. Multiple lymph nodes with heterogeneous echogenicity and well-defined margins. b. Color duplex mode showed central lymphatic hilus in the enlarged nodes. c. A core needle (arrow) was inserted into the lymph nodes for tissue harvest. d. The inner needle (arrow) was pushed forward to expose the notch for harvesting tissue specimens within the lymph nodes.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4008434&req=5

pone-0095886-g001: Sonographic presentation and USCB of KFD.a. Multiple lymph nodes with heterogeneous echogenicity and well-defined margins. b. Color duplex mode showed central lymphatic hilus in the enlarged nodes. c. A core needle (arrow) was inserted into the lymph nodes for tissue harvest. d. The inner needle (arrow) was pushed forward to expose the notch for harvesting tissue specimens within the lymph nodes.
Mentions: The patient was placed in a supine position with the neck hyper-extended. Each patient signed informed consents. The neck skin was disinfected and draped in the standard manner of antiseptic procedure. An ultrasound examination was performed with a 12 MHz linear probe (Toshiba Aplio SSA790 diagnostic ultrasound system, Tochigi-ken, Japan). For USCB, sonographic features and the location of targeted lymph nodes were evaluated and recorded. A color-duplex model was used to avoid vascular injury during USCB. After identifying the safest path to the targeted lesions, local anesthesia was applied. An 18-gauge biopsy needle (Temno Evolution Biopsy Devices, Cardinal Health Inc., Dublin, USA) was guided by ultrasound for sampling. After tissue harvesting, the specimen was removed from the needle notch, checked for quality and quantity, and fixed in formalin. One tissue sample was first collected. If the tissue quality and quantity was not good enough in the gross examination, the second shot was performed. Specimens harvested from cervical lesions were sent for pathological diagnosis. After the procedure, oozing from the puncture wound was controlled with pressure for 5 minutes. The patient was observed for 30 minutes. If there were no signs of complications, the patient was then discharged (Fig 1).

Bottom Line: Similar pathological presentations were found both in the specimens of USCB and OB.Sampling errors were found both in USCB and OB.OB can be applied only in the failed cases of USCB.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, National Taiwan University Hospital, Taiwan.

ABSTRACT
Kikuchi-Fujimoto disease (KFD) is a self-limited disease without any need of surgical treatments. Sampling of tissue is the only invasive procedure during the clinical course. However, the standard sampling procedure with accuracy, minimal invasiveness, and esthetic maintenance has not been established yet. In this study, a retrospective review of clinical utility and pathological presentations of the ultrasound-guided core biopsy (USCB) and the open biopsy (OB) in consecutive KFD patients. From 2010 to 2012, 34 consecutive patients were enrolled. USCB was performed in 11 patients, and OB was done in 26 patients. KFD was confirmed in 82% cases by USCB. Similar pathological presentations were found both in the specimens of USCB and OB. In the three patients who had received both USCB and OB, KFD was confirmed by USCB in one case, while two by OB. Sampling errors were found both in USCB and OB. For diagnosing KFD, USCB can serve as the first-line diagnostic tool. OB can be applied only in the failed cases of USCB.

Show MeSH
Related in: MedlinePlus