CORR insights?: Image guided core needle biopsy of musculoskeletal lesions: Are nondiagnostic results clinically useful?

摘要

Where Are We Now?: Biopsy of musculoskeletal lesions commonly is indicated for indeterminate lesions (particularly when symptomatic, progressive, or aggressive), and lesions that are likely to be malignant. Clinic or image-guided core needle biopsies have largely supplanted the historical gold standard of open biopsies at many tumor centers in recent years because they are generally reliable and less expensive. While lesions with determinate diagnoses on imaging are relatively few in number [4], many benign-appearing lesions do not require biopsy, and can simply be monitored for clinical or radiologic stability. Conversely, many malignant tumors have imaging features such as heterogeneity, necrosis, adjacent tissue invasion, or destruction. The size, depth or location of the tumor is also highly suggestive of a malignant or aggressive process. The prebiopsy clinical and radiologic differential diagnosis has important implications for the pathologic interpretation of biopsy specimens, particularly "nondi-agnostic" biopsies.