Cytological vs histological evaluation of percutaneous biopsies.

Fine-needle aspiration cytology yields sufficient diagnostic accuracy to compete with histology from punch biopsy for cancers of the lung and the prostate. For tumors of the breast, pancreas, thyroid, salivary glands, and kidneys, fine-needle aspiration cytology yields sufficient sensitivity and specificity when performed preoperatively; the exact tumor typing will follow surgical excision. In palpable lymph nodes, adrenals, and lungs, fine-needle aspiration biopsy is sufficient if metastases from a known primary tumor are suspected. Indications for punch biopsies and histological investigation are tumors of the liver, posterior and anterior mediastinum, retroperitoneum, soft tissues, and bone. In these conditions, cytological investigation alone provides insufficient typing accuracy. Suspected lymphomas in a retroperitoneal or mediastinal location should be punctured and may be classified from punch biopsies if the node is not easily reached by surgery. There are no indications for percutaneous biopsies in tumors of the skin, testes, and ovaries. Percutaneous fine-needle aspiration biopsies in general are associated with significantly lower complication rates than punch biopsies.