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Ultrasound guided neck biopsy in the diagnosis of malignancy – an audit of practice
Ultrasound guided neck biopsy in the diagnosis of malignancy – an audit of practice
Submitted on 01 Nov 2018

Dr Nuran Seneviratne, Dr Bikram Bhattacharjee, Miss Duaa Khair
Darent Valley Hospital
This poster was presented at British Institute of Radiology Annual Congress
Poster Views: 133
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Poster Abstract

Malignancy is a principal concern in cervical lymphadenopathy and thyroid masses. Ultrasound can be used to assess for features suggestive of malignancy and therefore appropriately select masses for ultrasound guided core biopsy (USGCB) or Fine Needle Aspiration Cytology (FNAC). This audit aims to determine the efficacy of these methods in the detection of malignancy.


A retrospective analysis of all neck ultrasounds in a five-month period was undertaken, with the ultrasound reports and, if samples were taken, pathology results reviewed.


Over the 5-month period, 233 neck ultrasounds were undertaken, 96 of enlarged lymph nodes (>10mm). 31 appeared indeterminate (18) or malignant (13), 19 of which were given USGCB with 7 showing malignant histology (36.8%) and 3 being inadequate samples (15.8%). 49 thyroid masses were imaged, 12 appearing malignant (1) or indeterminate (11) with 6 given USGCB yielding no malignant histology and 2 inadequate samples (33.3%). 7 thyroid masses were given FNAC (2 appearing benign, 5 appearing indeterminate) yielding 1 malignant cytology and 1 inadequate sample.


At this district general hospital, over a third of core biopsied lymph nodes yielded malignant histology, with a low (15.8%) inadequacy rate. Therefore, this investigation can be a useful alternative to surgical excision biopsy in the diagnosis of malignancy. However, thyroid core biopsies yielded no malignant histology. Within the limits of the small sample size, FNAC may be more useful in yielding malignancy that USGCB. This will be ascertained by further audit.
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