The role of core needle biopsies in the management of neck lumps

Background: King's College Hospital has proudly provided a one-stop neck lump clinic since 2012. These multidisciplinary clinics allow for rapid diagnoses due to in-clinic investigations. In April 2013, ultrasound-guided core needle biopsies (CB) were introduced as an alternative/adjunct to fine needle aspiration cytology (FNAC) and open biopsies for obtaining histo- logical diagnoses. Aim: To assess the impact of CB on the diagnosis of neck lumps compared to FNAC and open biopsies between April 2015 and May 2016. Method: Data was collected prospectively between April 2015 and May 2016 and analysed for numbers of FNAC, CB and open biopsies performed and diagnoses made. Result: 190 patients were seen on the clinic. 51 had a FNAC and 19 gave a diagnosis. Out of the remainder of these patients, 21 had a CB, and 12 gave a diagnosis. 8 only had a CB, of which 5 gave a diagnosis. 10 had an open biopsy; 4 had a previous FNAC and CB, 3 only a CB, 2 had neither and 1 had a FNAC. Conclusion: The introduction of CB has reduced the number of open bi- opsies performed. With increasing acceptance of this minimally-invasive technique, CB appear to be forming the key diagnostic investigation in patients with neck lumps.