How diagnostic is ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy technique)?: evaluation of 132 nonthyroid neck mass biopsies with pathologic analysis over 7 years at a single institution.

Objective: The purpose of this study was to evaluate the diagnostic value of ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy [FNC] technique).

Methods: With Institutional Review Board approval, all patients who had an ultrasound-guided neck mass FNC biopsy between January 2000 and December 2006 were retrieved from the ultrasound database. A total of 132 neck mass biopsies were performed in 124 patients. Patient demographics, procedure characteristics, and pathologic diagnoses were recorded.

Results: Of the 124 patients, 73 were female (mean age, 51.4 years). Biopsies were performed twice in 8 patients. A significant 200% increase from 2000 through 2002 to 2003 through 2004 and from 2003 through 2004 to 2005 through 2006 was found (P < .05). The most biopsied location was in the lymph nodes (34.8%), followed by perithyroid soft tissue masses (28.0%). A 25-gauge needle was used most frequently (97.7%). A total of 41 biopsies were diagnostic for thyroid diseases (31.1%), with the most common being thyroid papillary carcinoma. We found metastases in 31 biopsies (23.5%). Following these 2 were 29 lymph node biopsies. No major complications were noted. Of the 132 neck masses biopsied, 8 were pathologically nondiagnostic (93.9% diagnostic yield), yielding sensitivity, specificity, and accuracy of greater than 95% (97.1%, 95.2%, and 95.8%, respectively).

Conclusions: Ultrasound-guided FNC of neck masses is highly diagnostic. The diagnostic yield is especially high for detection of malignancy, including metastases. Together with a high clinical suspicion, ultrasound-guided needle biopsy should be performed to form a correct diagnosis and make appropriate management plans.