Utility of ultrasound‐guided fine‐needle aspiration in splenic lesions

Abstract

Indications of fine-needle aspiration (FNA) of spleen have increased as more splenic lesions are detected because of advanced imaging techniques. A retrospective analysis of cytological material of 36 patients on whom ultrasound-guided splenic FNA was performed was done. No complications were noted. There were 16 inflammatory lesions, 12 neoplastic and 8 cases were reported as descriptive either because of scant cellularity, blood only, or normal splenic cytology. Inflammatory lesions included nine cases of acute abscess, five cases of tuberculosis, and one case each of leishmaniasis and infarct. Neoplastic lesions included two benign (benign cyst and inflammatory pseudotumor) and 10 malignant lesions. Among malignant lesions, eight were non-Hodgkin lymphoma (NHL), one suspicious of NHL, and one desmoplastic small round cell tumor. FNA proved to be an effective procedure for reaching a microscopic tissue diagnosis and thus a splenectomy could be avoided in cases where it was not required.

Safety and utility of endoscopic ultrasound-guided fine-needle aspiration of focal splenic lesions: a retrospective analysis

“…Moreover, in contrast to previously published studies where the majority of patients had malignant FSL, all our patients had benign FSL that could be accurately diagnosed as well as medically managed, avoiding splenectomy in the majority of patients. Previously, US-guided splenic FNA has been reported to be a useful technique for the diagnosis of benign diseases such as tuberculosis [ 3 ]. There are also case reports describing the utility of EUS-guided FNA for the diagnosis of splenic tuberculosis [ 15 , 16 ].…”

“…Focal splenic lesions (FSL) are relatively rare and are caused by a variety of benign and malignant etiologies [ 1 , 2 ].Studies from western countries have reported a preponderance of malignant etiologies causing FSL [ 1 , 2 ].However, in tropical countries like India, various benign infectious diseases, such as kala-azar, tuberculosis, and malaria, are responsible for the majority of FSL [ 3 ]. Correct diagnosis of etiologies causing FSL requires histological evaluation; previously, many of these patients required histological evaluation of a splenectomy specimen for correct diagnosis [ 4 ].However, with recent advances in imaging techniques, FSL are being accurately diagnosed using image-guided fine-needle aspiration cytology (FNAC).…”

Endoscopic/Endobronchial Ultrasound-Guided Fine Needle Aspiration and Ancillary Techniques, Particularly Flow Cytometry, in Diagnosing Deep-Seated Lymphomas

“…Percutaneous US-guided FNA has been considered an effective and less invasive alternative to surgical splenectomy for the diagnosis of lymphoma [66,67,68]. However, the use of this diagnostic technique remains controversial.…”

Splenic Tuberculosis Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Aspiration

“…However, splenic abscess, lymphoma, or metastasis to spleen can closely mimic splenic TB and therefore histopathological diagnosis is essential for proper management. Ultrasound-guided FNA has been shown to be useful for diagnosis of splenic lesions 2. EUS also provides good images of the spleen through the gastric wall and in difficult situations especially inaccessible splenic lesions that are located closely to hilum.…”