Pu SH, Bao WYG, Jiang ZP, Yang R, Lu Q. Percutaneous ultrasound-guided coaxial core needle biopsy for the diagnosis of multiple splenic lesions: A case report. World J Gastrointest Surg 2024; 16(2): 616-621 [PMID: 38463358 DOI: 10.4240/wjgs.v16.i2.616]
Corresponding Author of This Article
Qiang Lu, MD, Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. luqiang@scu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2024; 16(2): 616-621 Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.616
Percutaneous ultrasound-guided coaxial core needle biopsy for the diagnosis of multiple splenic lesions: A case report
Sha-Hong Pu, Wu-Yong-Ga Bao, Zhen-Peng Jiang, Rui Yang, Qiang Lu
Sha-Hong Pu, Wu-Yong-Ga Bao, Zhen-Peng Jiang, Rui Yang, Qiang Lu, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Lu Q contributed to the study conceptualization and supervision; Pu SH contributed to manuscript writing; Yang R contributed to data collection; Bao WYG, Jiang ZP and Lu Q contributed to manuscript revision; and all authors have approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Lu, MD, Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. luqiang@scu.edu.cn
Received: November 8, 2023 Peer-review started: November 8, 2023 First decision: December 6, 2023 Revised: December 18, 2023 Accepted: January 25, 2024 Article in press: January 25, 2024 Published online: February 27, 2024
Abstract
BACKGROUND
The overlap of imaging manifestations among distinct splenic lesions gives rise to a diagnostic dilemma. Consequently, a definitive diagnosis primarily relies on histological results. The ultrasound (US)-guided coaxial core needle biopsy (CNB) not only procures sufficient tissue to help clarify the diagnosis, but reduces the incidence of puncture-related complications.
CASE SUMMARY
A 41-year-old female, with a history of pulmonary tuberculosis, was admitted to our hospital with multiple indeterminate splenic lesions. Gray-scale ultrasonography demonstrated splenomegaly with numerous well-defined hypoechoic masses. Abdominal contrast-enhanced computed tomography (CT) showed an enlarged spleen with multiple irregular-shaped, peripherally enhancing, hypodense lesions. Positron emission CT revealed numerous abnormal hyperglycemia foci. These imaging findings strongly indicated the possibility of infectious disease as the primary concern, with neoplastic lesions requiring exclusion. To obtain the precise pathological diagnosis, the US-guided coaxial CNB of the spleen was carried out. The patient did not express any discomfort during the procedure.
CONCLUSION
Percutaneous US-guided coaxial CNB is an excellent and safe option for obtaining precise splenic tissue samples, as it significantly enhances sample yield for exact pathological analysis with minimum trauma to the spleen parenchyma and surrounding tissue.
Core Tip: Multiple splenic lesions caused by infection, lymphoma, sarcoid, metastasis and infarction may have similar imaging features. The overlapping imaging characteristics of splenic lesions cause a diagnostic dilemma. Consequently, a definitive diagnosis primarily relies on histological results. We describe a case of multiple indeterminate splenic lesions and confirmed the diagnosis with an ultrasound (US)-guided coaxial core needle biopsy (CNB). US-guided CNB is a safe and efficient puncture technique providing valuable diagnostic information and patient treatment guidance.
