Objective To examine the role of core needle biopsy in the diagnosis of head and neck masses.
Design Prospective observational study.
Setting The otolaryngology–head and neck surgery department outpatient clinic of a large managed care organization.
Patients The study population comprised 40 consecutive patients referred for core needle biopsy of a cervicofacial lesion for which previous fine-needle aspiration biopsy had not provided the diagnosis.
Intervention Manually guided Delta Cut (Boston Scientific, Natick, Massachusetts) core needle biopsy was performed on neck masses larger than 1.5 cm.
Main Outcome Measure Diagnosis was indicated by core needle biopsy results without excisional biopsy.
Results A core needle biopsy specimen sufficient for diagnosis and treatment was obtained from 36 of the 40 patients (90%). In 22 patients, subsequent excisional biopsy or curative surgery was performed after core needle biopsy, and pathologic examination confirmed the diagnosis for 19 of these 22 patients (86%). For 12 of the remaining 14 patients (86%), core needle biopsy was successfully used to diagnose lymphoma. No complications resulted from the core needle biopsy.
Conclusions For lesions that require immunohistochemical staining or that remain undiagnosed after fine-needle aspiration, use of core needle biopsy should be considered before excisional biopsy. Core needle biopsy is a safe, effective, time-efficient, inexpensive procedure that can be an important tool for diagnosing head and neck masses, especially when lymphoma is suspected.
