Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of gall bladder lesions: an institutional experience

Abstract

Background: Carcinoma of the gall bladder is the most common malignancy of the biliary tract. Ultrasonography guided Fine Needle Aspiration Cytology (FNAC) plays a crucial role in early detection of gall bladder (GB) lesions. Early diagnosis of GB lesions is a necessity in view of rising trend in GB carcinoma related mortality in India. The aim of this study is to determine the diagnostic accuracy of pre-operative ultrasonography guided FNAC in the diagnosis of GB masses. Methods: This was a retrospective observational study performed at a tertiary care university hospital over a period of one and a half years. A total of 47 patients with clinico-radiological suspicion of GB malignancy were subjected to USG guided FNA. 20 of these patients underwent diagnostic Trucut biopsy in addition to FNA. Results: Forty-one out of 47 patients analyzed were positive for malignancy with female preponderance; MF ratio of 0.6:1. There were 29 females (61.8%) and 18 males (38.2%) in the range of 34 to 85 years. Cytomorphology was inconclusive for malignancy in two patients and unsatisfactory in one case. Two were labeled as chronic cholecystitis and one as acute cholecystitis. Adenocarcinoma was the most common malignancy found in 36 patients (76.6%). Conclusion: USG guided FNAC is a rapid, safe and successful diagnostic procedure with high sensitivity for diagnosis of GB lesions. In the present scenario of increasing incidence of GB malignancy, FNAC has proved to be a useful first choice of investigation in the detection of GB lesions.

Cytological evaluation of spectrum of Hepatobiliary and Pancreatic mass lesions

“…The most frequent GB lesions were the malignant cases which constituted 33 cases of Adenocarcinoma making it the most common, followed by 3 cases of Cholangiocarcinoma. Similar findings were also seen in studies by Selhi et al, 22 Rout et al 23 and Rahul Ranjan et al 1 Among these, there were 2 cases of Mucinous Adneocarcinoma, the smears of which showed clusters and acini of tumor cells having high N:C ratio, enlarged hyperchromatic and pleomorphic nuclei and moderate to scant amount of cytoplasm along with abundance of extracellular mucin. These findings are in concordance with a study by Singh et al 24 where it was also mentioned that the mucinous adenocarcinoma account for 2.5% of all carcinoma in gall bladder meeting the criteria of more than 50% extracellular mucin (WHO).…”

Utility of Rapid On-Site Evaluation during Bronchoscopy in the Diagnosis of Pulmonary Tuberculosis

“…Accurate diagnosis is extremely important as the disease is treatable with antituberculous therapy [17]. Cytological examination can provide useful diagnostic material for routine and ancillary techniques for the rapid and accurate diagnosis of TB [18,19]. Cytology, in many instances, is able to diagnose mycobacterial infection in a rapid and cost-effective manner without requiring surgery [20,21].…”

The Role of Fine Needle Aspiration Cytology in the Diagnosis of Gallbladder Cancer: A Systematic Review

“…When a patient is diagnosed with a gallbladder polyp that is symptomatic and/or deemed 'suspicious' according to the current criteria (size over 10 mm or size 6-9 mm and one more risk factor), or with another suspicious lesion (such as gallbladder thickening) instead of the patient being referred directly for a laparoscopic cholecystectomy, we suggest that the polyp is further investigated with FNAC. The procedure can be performed either under transabdominal or endoscopic ultrasound guidance depending on the availability and expertise of the involved center, as it carries a similar (minimal) complication rate [24,25]. If the FNAC is positive or suggestive of malignancy, then we suggest that the patient should be referred to hepatobiliary (HPB) surgeons in a center with high level of expertise in the field for further investigation and management.…”