Transthoracic fine-needle aspiration diagnosis of solid, subsolid, and partially calcified lung nodules: A retrospective study from a single academic center

Abstract

Background: The large-scale National Lung Cancer Screening Trial demonstrated an increased detection of early-stage lung cancers using low-dose computed tomography scan in the screening population. It also demonstrated a 20% reduction of lung cancer-related deaths in these patients. Aims: Although both solid and subsolid lung nodules are evaluated in studies, subsolid and partially calcified lung nodules are often overlooked. Materials and Methods: We reviewed transthoracic fine-needle aspiration (FNA) cases from lung nodule patients in our clinics and correlated cytological diagnoses with radiologic characteristics of lesions. A computer search of the pathology archive was performed over a period of 12 months for transthoracic FNAs, including both CT- and ultrasound-guided biopsies. Results: A total of 111 lung nodule cases were identified. Lesions were divided into three categories: solid, subsolid, and partially calcified nodules according to radiographic findings. Of 111 cases, the average sizes of the solid (84 cases), subsolid (22 cases), and calcified (5 cases) lesions were 1.952 ± 2.225, 1.333 ± 1.827, and 1.152 ± 1.984 cm, respectively. The cytological diagnoses of three groups were compared. A diagnosis of malignancy was made in 64.28% (54 cases) in solid, 22.72% (5 cases) in subsolid, and 20% (1 case) in partially calcified nodules. Among benign lesions, eight granulomatous inflammations were identified, including one case of solid, five cases of subsolid, and two cases of calcified nodules. Conclusions: Our study indicates that solid nodules have the highest risk of malignancy. Furthermore, the cytological evaluation of subsolid and partially calcified nodules is crucial for the accurate diagnosis and appropriate clinical management of lung nodule patients.

Role of image-guided fine needle aspiration cytology of lung lesions in diagnosis and primary care of patients: Experience in a Government Medical College of Eastern India

“…It is a simple way to obtain cellular material for a quick and accurate diagnosis. [ 6 ] The main purpose of guided FNAC is to diagnose malignancy for an early treatment, although it can also be used for benign neoplasm and infective condition such as Koch’s.…”

“…This is in coordination with other studies who have reported an incidence of 84% and 12% in non-small cell carcinoma and small cell carcinomas. [ 6 ] The incidence of squamous cell carcinoma [ Figure 1 ] was higher than adenocarcinoma [ Figure 2 ] on subtyping the non-small cell carcinoma. This was in concordance with the study done by Ahmed et al .…”

“…However, in the study by other researchers, adenocarcinoma has overtaken squamous cell carcinoma as leading primary malignant neoplasm, which is also a current global trend. [ 6 ]…”

Utility of liquid‐based cytology on residual needle rinses collected from core needle biopsy for lung nodule diagnosis

“…As another sampling modality, fine needle aspiration (FNA) is still used at some diagnostic centers. 5 Previous studies have shown that a combined lung FNA/CNB(both FNA and CNB) approach has a high diagnostic efficacy and accuracy for patients with lung mass lesions. 6 In addition, the cytology of the FNA material provides more evidence on the nucleus and cytoplasm morphology than hematoxylin and eosin-stained CNB.…”

Proteomic Analysis of the Air-Way Fluid in Lung Cancer. Detection of Periostin in Bronchoalveolar Lavage (BAL)

“…Currently, we commonly use the combination of imaging and histological assessment of the lesion for the diagnosis of lung cancer. Several types of specimens can be used for histomorphological evaluation, such as bronchial brushing and bronchoalveolar lavage (BAL) samples, and transbronchial fine-needle aspiration (EBUS-TBNA) biopsy with or without ultrasound guidance specimens ( 10 – 13 ). In addition, biomolecular markers in the blood, bronchial epithelium, and sputum are also being tested ( 14 , 15 ).…”