E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha.

Abstract
Background: Biopsy method of choice is a controversy issue for diagnosis of soft tissue sarcoma which are
traditionally been managed by wide excision surgery and radiotherapy. Chemotherapy is reserved for advanced cases.

Aims & Objective: The objective of study was to evaluate diagnostic accuracy of various modes of biopsy focusing on
image guided core needle biopsy (CNB).

Material and Methods: Current study includes 50 cases of soft tissue sarcoma from January 2010 to October 2012. The
Mode of biopsies included image guided CNB, open and excision biopsy. Effective accuracy of each was determined by
accuracy of biopsy to provide adequate tissue for histopathological and other special examinations like
immunohistochemistry to reach final diagnosis.

Results: Out of total 50 cases CNB was done in 13 cases, open biopsy in 2 cases and in 35 cases excision biopsy was
done. CNB was adequate in 92.31 % cases and 7.69 % cases it was inadequate. Open and excision biopsy were 100 %
adequate.

Conclusion: Image guided CNB is very helpful in early diagnosis and shows high accuracy especially for high-grade
sarcoma. It is less invasive compared to others and differentiate benign from malignant. It is handful when preoperative
diagnosis is essential for planning pre-operative chemotherapy especially in patients with primarily inoperable,
advanced tumour with compromised performance status or recurrent tumour. But it should be properly directed and
representative of whole tumour and require full radiological correlation by experienced hands. Tumours with myxoid
pattern, lipomatous tumours and low grade sarcomas encounters lower diagnostic accuracy on CNB.

Key words: Soft Tissue Sarcoma; Core Needle Biopsy; Excision Biopsy; Preoperative Diagnosis


 
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REFERENCES
1. World Health Organization. Classification of Tumours. In: Fletcher CDM, Unni KK, Mertens F, editors. Pathology and Genetics of Tumors of Soft Tissue. Lyon: IARC Press; 2002. pp. 12-224.
2. Kilpatrick SE, Cappellari JO, Bos GD, Gold SH, Ward WG. Is fine-needle aspiration biopsy a practical alternative to open biopsy for the primary diagnosis of sarcoma - Experience with 140 patients. Am J Clin Pathol 2001; 115(1):59-68. [DOI via Crossref]    [Pubmed]   
3. Hau A, Kim I, Kattapuram S, Hornicek FJ, Rosenberg AE, Gebhardt MC, et al. Accuracy of CT-guided biopsies in 359 patients with musculoskeletal lesions. Skeletal Radiol 2002;31(6):349-53. [DOI via Crossref]    [Pubmed]   
4. Mitsuyoshi G, Naito N, Kawai A, Kunisada T, Yoshida A, Yanai H, et al. Accurate diagnosis of musculoskeletal lesions by core needle biopsy. J Surg Oncol 2006;94(1):21-7. [DOI via Crossref]    [Pubmed]   
5. Yao L, Nelson SD, Seeger LL, Eckardt JJ, Eilber FR. Primary musculoskeletal neoplasms effectiveness of core-needle biopsy. Radiol 1999; 212(3):682-6. [DOI via Crossref]    [Pubmed]   
6. Welker JA, Henshaw RM, Jelinek J, Shmookler BM, Malawer MM. The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses. Cancer 2000; 89(12):2677-86. [DOI via Crossref]   
7. Domanski HA, Akerman M, Carlén B, Engellau J, Gustafson P, Jonsson K, et al. Core-needle biopsy performed by the cytopathologist: a technique to complement fine-needle aspiration of soft tissue and bone lesions. Cancer 2005;105(4):229-39. [DOI via Crossref]    [Pubmed]   
8. Jelinek JS, Murphey MD, Welker JA, Henshaw RM, Kransdorf MJ, Shmookler BM, et al. Diagnosis of primary bone tumors with image- guided percutaneous biopsy: experience with 110 tumors. Radiology 2002; 223(3):731-7. [DOI via Crossref]    [Pubmed]   
9. Fraser-Hill MA, Renfrew DL, Hilsenrath PE. Percutaneous needle biopsy of musculoskeletal lesions. 2. Cost-effectiveness. AJR Am J Roentgenol 1992; 158(4):813-8. [DOI via Crossref]    [Pubmed]   
10. Berning W, Freyschmidt J, Ostertag H. Percutaneous bone biopsy, techniques and indications. Eur Radiol 1996;6(6):875-81.
11. Leffler SG, Chew FS. CT-guided percutaneous biopsy of sclerotic bone lesions: diagnostic yield and accuracy. AJR Am J Roentgenol 1999; 172(5):1389-92. [DOI via Crossref]    [Pubmed]   
12. Kattapuram SV, Rosenthal DI. Percutaneous biopsy of skeletal lesions. AJR Am J Roentgenol 1991;157(5):935-42. [DOI via Crossref]    [Pubmed]   
13. Murphy WA, Destouet JM, Gilula LA. Percutaneous skeletal biopsy 1981: a procedure for radiologists—results, review, and recommendations. Radiology 1981;139(3):545-9.
14. Tehranzadeh J, Freiberger RH, Ghelman B. Closed skeletal needle biopsy: review of 120 cases. AJR Am J Roentgenol 1983;140(1):113-5. [DOI via Crossref]    [Pubmed]   
15. Gil-Sanchez S, Marco-Domenech SF, Irurzun- Lopez J, Fernandez-Garcia P, de la Iglesia-Cardena P, Ambit-Capdevila S.Ultrasound guided skeletal biopsies. Skeletal Radiol 2001;30(11):615-9. [DOI via Crossref]    [Pubmed]   
16. Pramesh CS, Deshpande MS, Pardiwala DN, Agarwal MG, Puri A. Core needle biopsy for bone tumours. Eur J Surg Oncol 2001;27(7):668-71. [DOI via Crossref]    [Pubmed]   
17. Torriani M, Etchebehere M, Amstalden E. Sonographically guided core needle biopsy of bone and soft tissue tumors. J Ultrasound Med 2002;21(3):275-81.
18. Thanos L, Mylona S, Kalioras V, Pomoni M, Batakis N. Percutaneous CT-guided interventional procedures in musculoskeletal system. Eur J Radiol 2004;50(3):273-7. [DOI via Crossref]    [Pubmed]   
19. Altuntas AO, Slavin J, Smith PJ, Schlict SM, Powell GJ, Ngan S, et al. Accuracy of computed tomography guided core needle biopsy of musculoskeletal tumours. ANZ J Surg 2005;75(4):187-91. [DOI via Crossref]    [Pubmed]   
20. Puri A, Shingade VU, Agarwal MG, Anchan C, Juvekar S, Desai S, et al. CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions- a prospective study of 128 cases. Skeletal Radiol 2006; 35(3):138-43. [DOI via Crossref]    [Pubmed]   
21. Zornoza J, Bernardino ME, Ordonez NG, Thomas JL, Cohen MA. Percutaneous needle biopsy of soft tissue tumors guided by ultrasound and computed tomography. Skeletal Radiol 1982;9(1):33-6. [DOI via Crossref]    [Pubmed]   
22. Fraser-Hill MA, Renfrew DL. Percutaneous needle biopsy of musculoskeletal lesions - effective accuracy and diagnostic utility. Am J Roentgenol 1992;158(4):809-12. [DOI via Crossref]    [Pubmed]   
23. Ng CS, Salisbury JR, Darby AJ, Gishen P. Radiologically guided bone biopsy: results of 502 biopsies. Cardiovasc Intervent Radiol 1998;21(2):122-8. [DOI via Crossref]   
24. Ayala AG, Zornosa J. Primary bone tumors: percutaneous needle biopsy—radiologic pathologic study of 222 biopsies. Radiology 1983;149(3):675-9.
25. Logan PM, Connell DG, O’Connell JX, Munk PL, Janzen DL. Image-guided percutaneous biopsy of musculoskeletal tumors: an algorithm for selection of specific biopsy techniques. AJR Am J Roentgenol 1996;166(2):137-141. [DOI via Crossref]    [Pubmed]   
26. Weiss SW, Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. 5th ed. St. Louis, Mo: Mosby: Elsevier store. 2008.
27. Heslin MJ, Lewis JJ, Woodruff JM. Core needle biopsy for diagnosis of extremity soft tissue sarcoma. Ann Surg Oncol 1997;4(5):425-31. [DOI via Crossref]    [Pubmed]   
28. Deyrup AT, Weiss SW. Grading of soft tissue sarcomas: the challenge of providing precise information in an imprecise world. Histopathology 2006;48(1):42-50. [DOI via Crossref]    [Pubmed]   
29. Bennert KW, Abdul-Karim FW. Fine needle aspiration cytology vs. needle core biopsy of soft tissue tumors. A comparison. Acta Cytol 1994;38(3):381-4.
30. Hussain HK, Kingston JE, Domizio P, Norton AJ, Reznek RH. Imaging-guided core biopsy for the diagnosis of malignant tumors in pediatric patients. AJR Am J Roentgenol 2001;176(1):43-7. [DOI via Crossref]    [Pubmed]   
31. Ball AB, Fisher C, Pittam M, Watkins RM, Westbury G. Diagnosis of soft tissue tumours by Tru-Cut biopsy. Br J Surg 1990;77(7):756-8. [DOI via Crossref]    [Pubmed]   
32. Kissin MW, Fisher C, Carter RL, Horton LW, Westbury G. Value of Tru-cut biopsy in the diagnosis of soft tissue tumours. Br J Surg 1986;73(9):742-4. [DOI via Crossref]    [Pubmed]   
33. Ball AB, Fisher C, Pittam M, Watkins RM, Westbury G. Diagnosis of soft tissue tumours by Tru-Cut biopsy. Br J Surg. 1990 Jul;77(7):756-8.
34. Strauss DC, Qureshi YA, Hayes AJ, Thway K, Fisher C, Thomas JM. The role of core needle biopsy in the diagnosis of suspected soft tissue tumours. J of Surg Oncol 2010;102(5):523-9. [DOI via Crossref]    [Pubmed]   
35. Fischerova D, Cibula D, Dundr P, Zikan M, Calda P, Freitag P, et al. Ultrasound-guided tru-cut biopsy in the management of advanced abdomino-pelvic tumors. Int J Gynecol Cancer 2008;18(4):833-7. [DOI via Crossref]    [Pubmed]   
36. Hoeber I, Spillane AJ, Fisher C, Thomas JM. Accuracy of Biopsy Techniques for Limb and Limb Girdle Soft Tissue Tumors. Annl of Surg Oncol 2001;8(1):80-7. [DOI via Crossref]   
37. Mankin HJ, Mankin CJ, Simon MA. The hazards of the biopsy, revisited: members of the Musculoskeletal Tumor Society. J Bone Joint Surg Am 1996;78(5):656-63.
38. Skrzynski C, Biermann JS, Montag A, Simon MA. Diagnostic accuracy and charge-savings of outpatient core needle biopsy compared with open biopsy of musculoskeletal tumors. J Bone Joint Surg Am 1996;78(5):644-9.
39. Wu JS, Goldsmith JD, Horwich PJ, Shetty SK, Hochman MG. Bone and Soft-Tissue Lesions: What Factors Affect Diagnostic Yield of Image-guided Core-Needle Biopsy? Radiology 2008;248(3):962-70.
40. Yang YJ, Damron TA. Diagnostic Accuracy of FNA and NCB in Musculoskeletal Lesions. Arch Pathol Lab Med 2004;128(7):759-64.

How to Cite this Article
Pubmed Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha. Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era. Int J Med Sci Public Health. 2013; 2(4): 960-965. doi:10.5455/ijmsph.2013.090720131


Web Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha. Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era. https://www.ijmsph.com/?mno=39793 [Access: April 05, 2022]. doi:10.5455/ijmsph.2013.090720131


AMA (American Medical Association) Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha. Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era. Int J Med Sci Public Health. 2013; 2(4): 960-965. doi:10.5455/ijmsph.2013.090720131



Vancouver/ICMJE Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha. Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era. Int J Med Sci Public Health. (2013), [cited April 05, 2022]; 2(4): 960-965. doi:10.5455/ijmsph.2013.090720131



Harvard Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha (2013) Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era. Int J Med Sci Public Health, 2 (4), 960-965. doi:10.5455/ijmsph.2013.090720131



Turabian Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha. 2013. Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era. International Journal of Medical Science and Public Health, 2 (4), 960-965. doi:10.5455/ijmsph.2013.090720131



Chicago Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha. "Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era." International Journal of Medical Science and Public Health 2 (2013), 960-965. doi:10.5455/ijmsph.2013.090720131



MLA (The Modern Language Association) Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha. "Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era." International Journal of Medical Science and Public Health 2.4 (2013), 960-965. Print. doi:10.5455/ijmsph.2013.090720131



APA (American Psychological Association) Style

Vasudha Bhagat, Kumarbhargav Kaptan, Reena Dudhat, Sonal Italiya, Mitesh Shah, Zarna Dhandha (2013) Selection of mode of biopsy in histopathological diagnosis of Soft tissue sarcoma depending on diagnostic accuracy and feasibility: Debatable issue in modern era. International Journal of Medical Science and Public Health, 2 (4), 960-965. doi:10.5455/ijmsph.2013.090720131





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