Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Percutaneous Ultrasound-Guided Fine-Needle Aspiration Cytology and Core-Needle Biopsy for Laryngeal and Hypopharyngeal Masses

  • Dongbin Ahn (Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University) ;
  • Gil Joon Lee (Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University) ;
  • Jin Ho Sohn (Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University) ;
  • Jeong Eun Lee (Department of Radiation Oncology, School of Medicine, Kyungpook National University)
  • Received : 2020.02.27
  • Accepted : 2020.07.29
  • Published : 2021.04.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion: US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

Keywords

References

  1. Marinone Lares SG, Allen JE. Safety of in-office laryngology procedures. Curr Opin Otolaryngol Head Neck Surg 2019;27:433-438 
  2. Preda L, De Fiori E, Rampinelli C, Ansarin M, Petralia G, Maffini F, et al. US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions. Eur Radiol 2010;20:1450-1455 
  3. Ahn D, Lee GJ, Sohn JH. Ultrasonographic swallowing examination for early detection of neopharyngeal fistula after salvage total laryngectomy: a preliminary study. Head Neck 2019;41:1804-1808 
  4. De Fiori E, Conte G, Ansarin M, De Benedetto L, Bonello L, Alterio D, et al. The role of ultrasound-guided transcutaneous tru-cut biopsy in diagnosing untreated and recurrent laryngo-hypopharyngeal masses. Eur J Radiol 2016;85:158-163 
  5. Kuribayashi S, Miyashita T, Nakamizo M, Yagi T, Kumita S. Utility of sonography for evaluation of clinical T1 and T2 glottic carcinoma. J Ultrasound Med 2009;28:1429-1440 
  6. Lopchinsky RA, Amog-Jones GF, Pathi R. Ultrasound-guided fine needle aspiration diagnosis of supraglottic laryngeal cancer. Head Neck 2013;35:E31-E35 
  7. Dedivitis RA, de Carvalho MB, Rapoport A. Transcutaneous fine needle aspiration biopsy of the preepiglottic space. Acta Cytol 2000;44:158-162 
  8. Wellenstein DJ, Schutte HW, Takes RP, Honings J, Marres HAM, Burns JA, et al. Office-based procedures for the diagnosis and treatment of laryngeal pathology. J Voice 2018;32:502-513 
  9. Cohen JT, Safadi A, Fliss DM, Gil Z, Horowitz G. Reliability of a transnasal flexible fiberoptic in-office laryngeal biopsy. JAMA Otolaryngol Head Neck Surg 2013;139:341-345 
  10. Ahn S, Jung S, Kim JY, Shin JH, Hahn SY, Oh YL. Evaluation of modified core-needle biopsy in the diagnosis of thyroid nodules. Korean J Radiol 2018;19:656-664 
  11. Chung SR, Baek JH, Choi YJ, Sung TY, Song DE, Kim TY, et al. The role of core needle biopsy for the evaluation of thyroid nodules with suspicious ultrasound features. Korean J Radiol 2019;20:158-165 
  12. Na DG, Baek JH, Jung SL, Kim JH, Sung JY, Kim KS, et al. Core needle biopsy of the thyroid: 2016 consensus statement and recommendations from Korean Society of Thyroid Radiology. Korean J Radiol 2017;18:217-237 
  13. Parasuraman L, Singh CA, Sharma SC, Thakar A. Ultrasonography guided fine needle aspiration cytology in patients with laryngo-hypopharyngeal lesions. Braz J Otorhinolaryngol 2020;86;237-241 
  14. Cohen JT, Bishara T, Trushin V, Benyamini L. Adverse events and time to diagnosis of in-office laryngeal biopsy procedures. Otolaryngol Head Neck Surg 2018;159:97-101 
  15. Kim SY, Chung HW, Oh TS, Lee JS. Practical guidelines for ultrasound-guided core needle biopsy of soft-tissue lesions: transformation from beginner to specialist. Korean J Radiol 2017;18:361-369 
  16. Lee YH, Baek JH, Jung SL, Kwak JY, Kim JH, Shin JH, et al. Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the Korean Society of Thyroid Radiology. Korean J Radiol 2015;16:391-401 
  17. Lippert D, Hoffman MR, Dang P, McCulloch TM, Hartig GK, Dailey SH. In-office biopsy of upper airway lesions: safety, tolerance, and effect on time to treatment. Laryngoscope 2015;125:919-923 
  18. Chen Z, King W, Pearcey R, Kerba M, Mackillop WJ. The relationship between waiting time for radiotherapy and clinical outcomes: a systematic review of the literature. Radiother Oncol 2008;87:3-16 
  19. Teppo H, Hyrynkangas K, Koivunen P, Jokinen K, Alho OP. Impact of patient and professional diagnostic delays on the risk of recurrence in laryngeal carcinoma. Clin Otolaryngol 2005;30:157-163 
  20. Hansen O, Larsen S, Bastholt L, Godballe C, Jorgensen KE. Duration of symptoms: impact on outcome of radiotherapy in glottic cancer patients. Int J Radiat Oncol Biol Phys 2005;61:789-794 
  21. Ahn D, Lee GJ, Sohn JH, Jeong JY. Fine-needle aspiration cytology versus core-needle biopsy for the diagnosis of extracranial head and neck schwannoma. Head Neck 2018;40:2695-2700 
  22. Novoa E, Gurtler N, Arnoux A, Kraft M. Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck 2012;34:1497-1503 
  23. Ahn D, Sohn JH, Yeo CK, Jeon JH. Feasibility of surgeon-performed ultrasound-guided core needle biopsy in the thyroid and lymph nodes. Head Neck 2016;38 Suppl 1:E1413-E1418 
  24. Naidu H, Noordzij JP, Samim A, Jalisi S, Grillone GA. Comparison of efficacy, safety, and cost-effectiveness of in-office cup forcep biopsies versus operating room biopsies for laryngopharyngeal tumors. J Voice 2012;26:604-606