Is percutaneous computed tomography-guided biopsy sufficient to establish indolent lymphoma transformation?

INTRODUCTION: The aim of the study was to retrospectively evaluate the technical features, efficacy, accuracy, and relevant complications of computed tomography-guided biopsies in various anatomical localizations when diagnosing indolent lymphoma transformations, relapses, duplicate malignant diseases or benign processes. MATERIAL AND METHODS: From December 2007 to December 2017, 81 percutaneous biopsy procedures in 72 patients for tumors, sizes 17–232 mm in diameter (median length: 39 mm), were performed in patients with known indolent lymphomas in their clinical history. The patients were men in 41 cases and women in 31 cases, aged 36 to 86 years. RESULTS: In 79 cases (97.5%; 95% CI: 91.3–99.7) results were true positive or true negative; only 2 interventions (2.5%; 95% CI: 0.3–8.6) were histologically false negative. Transformation was verified in 29 cases (35.8%; 95% CI: 25.4–47.2), relapses in 30 cases (37%; 95% CI: 26.6–48.5), duplicate malignancy in 15 cases (18.5%; 95% CI: 10.8–28.7) and benign processes in 7 cases (8.7%; 95% CI: 3.5–17.0). Eight complications in total were revealed, 7 of which were in consequence of thoracic cavity biopsy. A statistically significant relationship between the complication incidence and anatomical localization in the thoracic cavity was identified (p = 0.0104). CONCLUSIONS: Percutaneous CT guided biopsy performed in patients with a history of indolent lymphoma had high accuracy in establishing the correct diagnosis regarding transformation, relapse, duplicate malignancy or a benign process. Simultaneously, the complication rate was low.