CT guided transthoracic FNAC was done in 49 cases with an intention to evaluate the efficacy and safety of CT guided thransthoracic FNAC of lung lesions of various sizes and locations. We divided our cases according to site (Central/peripheral) and size (Small/ large). CT guided transthoracic FNAC diagnosed 47 out of 49 cases 95.9% cases (100% large central, 87.5% small central, 100% large peripheral and 80% small peripheral). We observed complications in 8.2% of cases. All these complications were minor in nature and responded to symptomatic and conservative treatment so considering its simplicity, safety, rapidity and high diagnostic yield and more importantly usefulness in diagnosing difficult to approach lesions and in small central lesions.
Unguided transthoracic FNAC was done in 71 patients while CT guided transthroacic FNAC was done in 49 cases. We divided our cases according to site (central/peripheral) and size [less than 2 cm (small)/more than 2 cm (large)]. Unguided transthoracic FNAC diagnosed 56/71 i.e. 78.87% of cases (83.33% large central, 30.76% small central, 100% large peripheral and 57.14% small peripheral lesions). CT guided transthoracic FNAC diagnosed 47/49 i.e. 95.9% cases (100% large central, 87.5% small central, 100% large peripheral and 80% small peripheral). We observed complications in 18.3% cases by unguided (minor chest pain 39.3% was most common) while 8.2% in CT guided transthoracic FNAC. All these complications responded to symptomatic and conservative treatment. We diagnosed 66/71 patients by both unguided and CT guided transthoracic FNAC. Sensitivity of unguided FNAC was 85.11% specificity 100% and predictive value for negative test 22.22% with no false positive case. Percentage of false negatives was 14.9%. So considering its simplicity, safety, rapidity and high diagnostic yield unguided transthoracic FNAC should be performed routinely in properly selected patients by experienced people. CT guided transthoracic FNAC is option and useful in difficult to approach lesions and in small central lesions.
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