Role of FNAC in palpable chest wall lesions in developing country

Abstract

Palpable chest wall lesions are unusual manifestation of an underlying thoracic pathology and it is difficult to diagnose them with their diverse spectrum ranging from benign to malignant. Considering the exposure of patient to invasive biopsy/excision and the risk of local complications, FNAC is now being increasingly used in the primary assessment of these lesions. Objectives of this study were to report the spectrum of chest wall lesions in the population of a developing country and evaluating the diagnostic role of FNAC. All the patients who presented with palpable cutaneous or subcutaneous chest wall swelling during a period of January 2003 to August 2010 were reviewed retrospectively. May Grunwald Giemsa and Papanicolaou stained aspirates were examined, along with special stains. Seven hundred seventy-three cases were subjected to chest wall FNAC, of which 726 (93.9%) cases were satisfactory. Age ranged from 1 to 93 years with M:F = 0.92:1. 358 (49.3%) were diagnosed as inflammatory and 368 (50.7%) were neoplastic lesions. Two-hundred thirty four cases (32.2%) were diagnosed as mycobacterial abscess (likely tuberculous). Of the neoplastic lesions, 153 were malignant with carcinomas being predominant (88.2%). Malignant cases comprised of scar site recurrence in breast carcinoma (73 cases), metastatic carcinomas (62 cases), primary sarcomas (eight cases), hematological neoplasms (six cases), and miscellaneous group (four cases). Overall malignant lesions accounted for 21.1% (153/726) of satisfactory chest wall aspirates. FNAC is very useful and simple investigation for early diagnosis of chest wall abscesses, cutaneous metastases from visceral malignancies, and scar site recurrence in breast carcinoma.

Role of FNAC in diagnosing lesions of hand and wrist

“…AFB positivity is reported variably between 10% and 70%. 10 Ganglion is the most common benign, non-neoplastic (tumor-like) lesion in the hand and wrist with incidence reported between 49% and 74%. 7,13 Ganglion cyst is a degenerative condition.…”

“…However, in developing countries with high prevalence of tuberculosis, features suggestive of tuberculosis like presence of epithelioid cell granulomas, multinucleated giant cells, and caseous necrosis are considered enough to start ATT. AFB positivity is reported variably between 10% and 70% . FNAC can provide an initial clue to the diagnosis of tuberculosis, and treatment can be continued based on initial response.…”

Cytomorphological spectrum of hand, wrist, and foot lesions at tertiary care center in central India

“…7 AFB positivity is reported variably between 10% and 70%. 8 In our study, three cases were AFB-positive. The frequency and cytologic findings of specific benign lesions of our study correspond with the previously published studies.…”

“…AFB positivity is reported variably between 10% and 70% 8 . In our study, three cases were AFB‐positive.…”