Ultrasound-Guided Tissue Core Biopsies in Supraclavicular Lymph Nodes in Patients with Suspected Thoracic Malignancies

Background: Supraclavicular (SC) lymph node metastases are important in the analysis of thoracic malignancies for staging as well as for diagnosing purposes. Ultrasound (US) guidance visualises lesions very precisely, enabling tissue biopsies in real-time mode. Objectives: To report on the diagnostic qualities of SC tissue core biopsies (TCB). Methods: A retrospective database analysis was performed in TCB performed under US guidance in SC nodes in patients suspected of having a thoracic malignancy. Clinical characteristics and results of diagnostic evaluations were analysed. Results: Between October 2008 and October 2014, 67 sessions for TCB in 65 patients were performed. The diagnostic accuracy of TCB for all diagnoses is 90%, with a sensitivity of 89%. For malignant diagnoses, the sensitivity of US-guided TCB is 93%. In 20 patients, molecular analysis for EGFR and KRAS was performed, with a diagnostic success rate of 95%. One patient suffered a moderate haemorrhage after TCB. Conclusion: TCB of SC nodes in the analysis of suspected thoracic malignancy is safe and has a high diagnostic accuracy in determining tumour subtype as well as molecular analysis.