Study of computed tomography-guided fine needle aspiration cytology of thoracic lesions

Abstract

Background:Thoracic lesions include a variety of benign and malignant lesions of lung, pleura, chest wall and mediastinum. Transthoracic fine needle aspiration cytology (TFNAC) is a well established technique for work up of thoracic lesions. Computed tomography (CT) has extended the use of FNAC, because it is accurate for localization, needle puncture and above all it permits evaluation of lesions less than 1 cm. This diagnostic modality has a high sensitivity, specificity and is of relatively low cost.Aims:To assess the role of CT-guided FNAC in the diagnosis of thoracic lesions.Materials and Methods:Eighty three patients with various thoracic lesions were evaluated by CT guided FNAC. The cytologic findings were compared with cell blocks whenever available.Results:Conclusive opinion was offered on cytology smears in 80 patients. Lesions of the lung were the most common. Neoplastic lesions in our study accounted for 65% of cases. The sensitivity and specificity of the study were 93.33% and 100%, respectively.Conclusion:CT-guided TFNAC is a low cost, safe, minimally invasive and accurate diagnostic procedure with high sensitivity and specificity and when interpreted in conjunction with clinical and radiological data can prevent some of the pitfalls in diagnosis.

Cell blocks histopathology versus FNA cytology in diagnosis of primary malignant lung mass: A comparative study

“…16 The variation in technique may have contributed to either the success or failure of obtaining adequate samples which are largely dependent on the skill of the aspirator and high cellularity of the aspirate. The sensitivity and specificity of the present study are comparable to that of Khouri et al, 17 Hamper et al 18 and Rangaswamy et al 19 In a study done by Mondal, CT guided FNAC showed almost perfect agreement with histological diagnosis. 3 So FNAC was found to be highly accurate (95%) in the diagnosis of lung mass as almost similar finding was shown by previous studies.…”

Role and Accuracy of Computed Tomography Guided Fnac of Thoracic Lesion.

“…One case each of benign and malignant mesothelioma was also seen in the study. Incidence of pleural lesions was found low in our study, which was comparable to other studies like Rangaswamy et al 16 and Kalhan S et al 10 . Lower specificity at 76% was recorded by Jayashankar et al 9 and at 84% by Basnet et al 13 Positive predictive value of our study was 100% which was similar to that of found in studies by Singh JP et al 12 and Sarkar RN et al 8 and negative predictive value was found to be 80% which was almost comparable to that found in studies done by Singh JP et al 12 (75%) and Basnet et al 13 (81%).…”

“…Among neoplastic lesions, the malignant lesions were predominant accounting for 97.56% which was similar to the studies by Rangaswamy et al 16 (94.23%) and Singh JP et al 12 (81.8%) . This indicates that the usefulness of TTFNAC is limited in benign lesions.…”

“…The prevalence of small cell carcinoma and poorly differentiated carcinoma was equal and of 3.44% each. This pattern of prevalence was similar to the study done by Rangaswamy et al 16 and Sing JP et al 12 There were three cases of metastatic malignancy, one in lung which was from known case of carcinoma breast , other in paraspinal region, from known case of carcinoma stomach and third was in thoracic vertebrae from a known case of bronchogenic malignancy . One case each of benign and malignant mesothelioma was also seen in the study.…”

“…The percentage of malignancy was at 77% had similarity in findings by Kalhan S et al 14 16 where 65.2% lesions were neoplastic and 32% were non-neoplastic. Out of 11 non neoplastic lesions; 5 were from lung, 2 each from mediastinum & thoracic vertebrae and one each from hilar and paraspinal regions.…”