Objective: Image guided fine needle aspiration cytology (FNaC) is a safe, simple, rapid, cost effective and accurate modality in evaluation of deep seated lumps (abdominal, pelvic and intrathoracic masses) which are unapproachable by blind FNaC. In this study, a critical analysis of the utility of image guided FNaC in deep seated and otherwise inacessible mass lesions was carried out.
Material and Method:Fifty-four ultrasound (USG) or computed tomography (CT) guided FNaCs from lumps at any location in the body, that is, thoracic, abdominal, pelvic etc over a period of 3 years (January 2012-December 2014) were included in the study. The most common site aspirated, the indications for a guided aspiration and the accuracy of aspiration cytology in comparison to the histological diagnosis were evaluated, wherever possible.Results: Fifty-four image guided FNaCs were performed (46 USG guided and 8 CT guided). Inconclusive, inflammatory, benign tumors, suspicious and malignant lesion rates were 5.6%, 29.6%, 11.1%, 5.6%, and 48.1%, respectively. The most common site was the liver (25.5%), followed by the thyroid (18.5%), lung (14.8%), gallbladder (11.1%), and lymph nodes (7.4%). Cytohistological correlation could be performed in 32 cases with a diagnostic accuracy of 100%.
Conclusion:FNaC coupled with a diagnostic imaging technique such as USG or CT can improve the diagnostic yield and a definite diagnosis can be reached in most of the cases.
Malignant thyroid tumors of follicular origin comprise a spectrum, with the indolent well-differentiated thyroid carcinoma (WDTC) at one end and lethal anaplastic thyroid carcinoma (ATC) at the other. Poorly differentiated thyroid carcinoma (PDTC) lies intermediately between WDTC and ATC in terms of morphology and prognostic standpoint. This thyroglobulin producing neoplasm accounts for 4-7% of all thyroid malignancies. PDTC has been controversial due to lack of defined diagnostic criteria. We hereby report a case of PDTC in a 42-year-old female presenting with neck swelling, pain, and dysphagia for 10 months. She was diagnosed as colloid goiter on fine-needle aspiration cytology. On imaging, a large complex thyroid with central neck nodes was seen. Total thyroidectomy and central neck node dissection were done. Based on the morphology, immunostaining, and the diagnostic criteria, a diagnosis of PDTC was made. PDTC is a diagnostic challenge due to its rarity and previous equivocal diagnostic criteria.
Oncocytoma are benign neoplasms constituting approximately 1.5% of all salivary gland tumors. Their preferred location is in the parotid, oncocytomas of the submandibular gland are however definitely rare. Fine needle aspiration cytology (FNAC) is increasingly being employed in the diagnostic work up of salivary gland lesions, moreover these aspirates can prove challenging because of overlapping between various lesions. We describe the cytological findings of oncocytomas and their diagnostic differentials in a 17year old male with a submandibular oncocytoma. This case is unique because of the younger age and rare location of the lesion.
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