Evaluation of intrathoracic lesions by image guided fine needle aspiration cytology

Abstract

Background: Fine needle aspiration cytology has become an indispensable tool for diagnosis of intrathoracic lesions. The purpose of this study was to evaluate the spectrum of intrathoracic lesions by image guided fine needle aspiration cytology.
 Materials and Methods: This was a prospective study of 100 patients, who underwent image guided fine needle aspiration cytology of intrathoracic lesions from December 2015 to November 2016 in the Department of Pathology, Institute of Medicine, Tribhuwan University Teaching Hospital.
 Results: Of the 100 cases, diagnostic material was obtained in 86 cases, which included 69 cases (80.23%) from lung, 7 cases (8.13%) from pleura and 10 cases (11.62%) from mediastinum. Lung lesions constituted of 61 neoplastic lesions (88.40%), 3 cases (4.34%) suspicious of malignancy, 3 cases (4.34%) negative for malignancy and 2 non- neoplastic lesions (2.89%). Squamous cell carcinoma was the most common lesion of the lung. Pleural lesions consisted of 5 neoplastic cases (71.42%), 1 non- neoplastic case (14.28%) and 1 negative for malignancy (14.28%). Mediastinal lesions consisted of 7 neoplastic lesions (70.00%) and 3 non- neoplastic lesions (30.00%). Biopsy for histopathological examination was available in 30 cases. The concordance of diagnosis of lung lesions by fine needle aspiration cytology and histopathology was 90.90%. Image guided FNAC had sensitivity of 95.83% and specificity of 50.33% in diagnosing intrathoracic lesions. The positive predictive value of image guided FNAC in diagnosis of intrathoracic lesions was 92.00% and negative predictive value of 66.67 percent.
 Conclusions: Image guided fine needle aspiration cytology of intrathoracic lesions permits categorization and distinction between non- neoplastic and neoplastic lesions.

Role of image guided fine needle aspiration cytology of lung lesions in patients visiting Gandaki Medical College

“…In biopsy specimens, the most common was also squamous cell carcinoma 30( 53.5%) followed by adenocarcinoma 14(25%), benign lesion 10(17.85%), and small cell carcinoma 2(3.57%) which is similar to the study done by Abdulhameed T et al 12 , Shrestha M et al 14 whereas in the study done by Mohanty et al 21 and Shah D et al 11 adenocarcinoma was predominant.…”

“…There was a predominance of females in our study which was in contrast with other studies. [14][15][16] Predominance of females in our study may be because lung cancer is now the cause of cancer mortality in women worldwide. 17 Among the patients (60.6%) were active smokers which is similar to the study done by Modi MB et al 18 .…”

“…19 (17.43%) cases were non-diagnostic because the sample was hemorrhagic which was similar to the study done by Ahmed Z et al 1 , Shrestha M et. al 14 , and Dahlstrom JE et al 20. Squamous cell carcinoma among patients can be explained due to the higher prevalence of smoking. In contrast to our study, Shrestha MK et al 13 and Modi MB et al 18 showed the most common finding as adenocarcinoma followed by squamous cell carcinoma.…”