Case 93: Multidirectional Rotation of the Biopsy Needle for Better Sampling - Left Para-Aortic Retroperitoneal Node Biopsy
This 86-years old, treated earlier for endometrial carcinoma presented with lung, skeletal and nodal lesions. A biopsy of one of the retroperitoneal nodes was requested.
I have used this case to highlight how I sample different parts of the tumor by rotating the biopsy gun in different directions. This is a process I use daily in almost all biopsies, often combined with other techniques such as angulating the needle, tilting the needle or bending the needle.
Shout-out to #evacularrounds who mentioned this a few months ago, though I prefer the term multidirectional rotation to "flipping".
180 degree flip of the biopsy gun so that the cutting edge faces outwards and away from the central necrotic area can make all the difference #MedTwitter #CardioTwitter #radres #FOAMrad #radiology #InterventionalRadiology #irad #biopsy pic.twitter.com/O52NR1oJds
— Endovascular Rounds (@evascularrounds) March 23, 2022
The video explains the rest.
The post is free till 21st June, 2022.
Updated ToC
Region: Retroperitoneum
Age: 86
Findings: Lung, skeletal and retroperitoneal nodal lesions
Lesion Biopsied: Left para-aortic retroperitoneal node
Size of Lesion: Not relevant
Gun: 18 G Bard
No of cores: 5 for histopath and 2 for microbiology
Sedation: No
Position & Approach: Prone
Time Taken (marker to wash-out): 8 mins
Complication: None
Level of Difficulty: 2/5
Diagnosis: Metastasis from endometrial carcinoma
Other Cases