Fine-Needle Aspiration Cytology of Retroperitoneal Lesions: A 5-Year Experience with an Emphasis on Cytohistological Discrepancy

Abstract

Background: The retroperitoneal space contains various organs which can be affected by various non-neoplastic and neoplastic pathological processes. A diagnosis of these retroperitoneal lesions is often difficult. Fine-needle aspiration cytology (FNAC) under image guidance is now becoming an effective tool for the initial evaluation of retroperitoneal lesions. Objective: The present study was undertaken to evaluate the role of ultrasound-guided FNAC in the diagnosis of retroperitoneal lesions in comparison to histopathology and to assess the probable causes of failure in cases of pitfalls in cytodiagnosis. Materials and Methods: During the study period of 5 years, a total of 104 cases of retroperitoneal lesions were aspirated under USG guidance. Seven cases yielded inadequate material, the remaining 97 cases were included in the study group. Results: Out of 97 cases, the kidney was the most common organ aspirated (27 cases; 27.8%). Malignant lesions (68 cases; 70.1%) were much more frequent than benign or non-neoplastic lesions (29 cases; 29.9%). Tuberculosis was the most common non-malignant lesion (14 cases) and renal cell carcinoma was the most frequent malignant lesion encountered (15 cases). In 5 cases (7.9%), the histological diagnosis showed inconsistent results in comparison to cytodiagnosis. Conclusion: USG-guided FNAC is a safe, rapid, relatively cheap and fairly accurate procedure for the assessment of retroperitoneal lesions.

A systematic review on performance characteristics of FNA of renal lesions: It is time for a standardized classification system

“…The abstracts of the remaining 343 articles were reviewed, and the criteria for inclusion in the systematic analysis were determined. Twenty‐three articles 10–32 with a sample size >20 that presented data were included for which true‐positive and true‐negative rates could be calculated (comparing FNA vs. a follow‐up surgical pathology result as the gold‐standard method). The PRISMA flow chart is shown in Figure 1.…”

“…Eight articles reported that rapid on‐site (cytologic) examination (ROSE) was performed during renal FNA. The data are summarized in Tables 2, 3, and 4 10–35 …”

“…Forest plots were constructed to depict the individual study sensitivity, specificity, and corresponding 95% confidence intervals for each study and the variations across the included studies (Figure 3A,B). 10–32 …”

Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

“…Despite advances in diagnostic imaging techniques and the use of tumor markers, even with the development of spiral computed tomography (CT) and positron emission tomography (PET), the differentiation of pancreatic cancer and focal pancreatitis or other mass lesions, such as retroperitoneal or pelvic lesions remains problematic (1)(2)(3). Since the first report of endoscopic ultrasound (EUS)-fine needle aspiration (FNA) of the pancreas by Vilmann et al (4) in 1992, EUS-FNA has been considered as a standard method for the diagnosis of mass lesions in the pancreas because it is an effective and accurate procedure with a low complication rate (5)(6)(7)(8) and, moreover, it provides cytological or pathological confirmation of benign or malignant disease.…”