Sensitivity of Core Needle Biopsy in the Diagnosis of Lymphoma: A Meta-analysis

Tuesday, October 1, 2024

8:12 AM – 8:18 AM EDT

Location: MBCC, 208

Disclosure(s):

Chloe J. Cottone, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Katherine A. Kozlowski, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Lymphoma commonly presents with adenopathy in the head and neck, where core needle biopsy (CNB) is the preferred diagnostic modality. Literature surrounding the sensitivity of CNB as the diagnostic modality across lymphoma subtypes is mixed. To our knowledge, a meta-analysis investigating the sensitivity of CNB within lymphoma subtypes has yet to be carried out.

Methods: This meta-analysis was performed following PRISMA guidelines. A search for articles published between 2003 and 2023 was run in EMBASE and PubMed. Articles were included if they examined the sensitivity of CNB and stratified lymphoma cases by subtype in statistical analyses. Articles were excluded if they did not use CNB as the diagnostic modality and lacked sufficient data to evaluate sensitivity in lymphoma subtypes. Data was collected across 21 lymphoma subtypes. A random effect logistic regression model was used to pool sensitivity data. Pooled sensitivity estimates and corresponding 95% confidence intervals were obtained from model estimates and all analyses were conducted at a significance of 0.05.

Results: Our search yielded 1,396 articles. Screening yielded 32 articles with 3,027 biopsies. Across all subtypes, estimated sensitivity was 86.4% (CI:76.1–96.7). There was significant heterogeneity among disease subtypes (p < 0.001). Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL), Mantle Cell Lymphoma (MCL) and Diffuse Large B Cell Lymphoma (DLBCL) exhibited highest sensitivities at 97.8% (CI:94.2–99.1), 97% (CI:92.2–98.9), and 94.5% (CI:91.44–96.5), respectively. Low Grade B Cell not otherwise specified, Natural Killer/T cell, and Angioimmunoblastic Lymphomas demonstrated lowest sensitivities at 71% (CI:44.5–88.2), 75.4% (CI:23–96.9), and 77.1% (CI:54.2–90.5), respectively. Hodgkin's Lymphoma yielded a sensitivity of 83.7% (CI:76.2–92.8).

Conclusions: CNB is highly sensitive in the diagnosis of some lymphoma subtypes, particularly MCL, DLBCL and CLL. Knowledge of CNB performance relative to each subtype is essential to avoid unnecessary excisional node biopsies and facilitate timely treatment.

Presenting Author(s)

Chloe J. Cottone, BA

Medical Student
Jacobs School Medicine and Biomedical Sciences at the University at Buffalo
Bufalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Katherine A. Kozlowski, BS

Medical Student
Jacobs School Medicine and Biomedical Sciences at the University at Buffalo
Getzville, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
JS

Joshua Sorrentino, BS

Medical Student
Jacobs School Medicine and Biomedical Sciences at the University at Buffalo, United States

Disclosure information not submitted.
XM

Xiaoyi Ma, PhD

Biological Statistician
Roswell Park Comprehensive Cancer Institute, United States

Disclosure information not submitted.
KS

Kelly Stahovic, BS

Medical Student
Jacobs School Medicine and Biomedical Sciences at the University at Buffalo, United States

Disclosure information not submitted.

Senior Author(s)

AA

Ayham Al Afif, MD

Head and Neck Surgeon
Roswell Park Comprehensive Cancer Institute, United States

Disclosure information not submitted.