Computed tomography guided fine needle aspiration cytology of mass lesions of lung: our experience in a tertiary care hospital
DOI:
https://doi.org/10.18203/2320-6012.ijrms20214708Keywords:
CT, FNAC, Malignant categoryAbstract
Background: The present study was undertaken to evaluate the diagnostic usefulness of image guided fine needle aspiration cytology (FNAC) in various lung lesions-both neoplastic and non- neoplastic.
Method: This retrospective study (Jan 2016-Dec 2018) included 34 cases of lung lesions with strong probable radiological diagnosis of lung neoplasm. Computed tomography (CT)-guided FNAC was performed and cytological smears were stained with May-Grunwald-Gimesa (MGG) stain and conventional Papanicolaou (Pap) stain.
Result: A total of 34 cases of lung masses in our study, included 21 males (61.7%) and 13 females (38.2%). The age interval varied from 15 to 85 years; majority presenting in 6th and 7th decade of age. Smears were broadly categorized into unsatisfactory (n=2;5.88%), benign (n=3;8.82%), suspicious of malignancy (n=2;5.88%) and malignant lesions (n=27;79.41%). Benign category included 2 cases of tuberculosis and 1 case of abscess. Malignant category included the cases, diagnosed as squamous cell carcinoma(n=8); poorly differentiated carcinoma (n=6); small cell carcinoma (n=3); adenoma carcinoma (n=2); primitive neuroectodermal tumor (n=2); non-Hodgkins lymphoma (n=2) and plasmacytoma (n=1). Malignant category also included one case each of Metastatic Adenocarcinoma, adenoid cystic carcinoma, renal cell carcinoma with known primary site of Tumours.
Conclusions: CT-guided FNAC is a less expensive, simple, fast, relatively safe and accurate procedure in the diagnosis of difficult lung lesions; the major limitation being the adequacy of the aspirate.
References
Iwasaki A, Kamihara Y, Yoneda S, Kawahara K, Shirakusa T. Video-assisted thoracic needle aspiration cytology for malignancy of the peripheral lung. Thorac Cardiovasc Surg. 2003;51:89-92.
Kim HK, Shin BK, Cho SJ, Moon JS, Kim MK, Kim CY et al. Transthoracic fine needle aspiration and core biopsy of pulmonary lesions. A study of 296 patients. Acta Cytol. 2002;46:1061-8.
Gullón JA, Fernández R, Medina A, Rubinos G, Suárez I, Ramos C et al. Transbronchial needle aspiration in bronchogenic carcinoma with visible lesions: Diagnostic yield and cost. Arch Bronconeumol. 2003;39:496-500.
Levine MS, Weiss JM, Harrell JH, Cameron TJ, Moser KM. Transthoracic needle aspiration biopsy following negative fiberoptic bronchoscopy in solitary pulmonary nodules. Chest. 1988;93:1152-5.
García Río F, Díaz Lobato S, Pino JM, Atienza M, Viguer JM, Villasante C et al. Value of CT-guided fine needle aspiration in solitary pulmonary nodules with negative fiberoptic bronchoscopy. Acta Radiol. 1994;35:478-80.
Sider L, Davis TM Jr. Hilar masses: Evaluation with CT-guided biopsy after negative bronchoscopic examination. Radiology. 1987;164:107-9.
Swischuk JL, Castaneda F, Patel JC, Li R, Fraser KW, Brady TM et al. Percutaneous transthoracic needle biopsy of the lung: Review of 612 lesions. J Vasc Interv Radiol. 1998;9:347-52.
Hiraki T, Mimura H, Gobara H, Iguchi T, Fujiwara H, Sakurai J et al. CT fluoroscopy-guided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles: Diagnostic yield and risk factors for diagnostic failure. Chest. 2009;136:1612-7.
Ohori NP, Hoff ER. Cytopathology of pulmonary neoplasia. In: Tomashefski JF Jr., Cagle PT, Farver CF, Fraire AE, editors. Dail and Hammar's Pulmonary Pathology. 3rd ed. Vol. II. New York, NY: Springer. 2008;767-95.
Kline TS. Handbook of Fine Needle Aspiration Biopsy Cytology, 2nd ed. New York, Churchill Livingstone. 1988.
Das DK, Pant CS, Pant JN, Sodhani P. Transthoracic (percutaneous) fine needle aspiration cytology of pulmonary tuberculosis. Tuber Lung Dis. 1995;76:84-9.
Tan KB, Thamboo TP, Wang SC, Nilsson B, Rajwanshi A, Salto-Tellez M. Audit of transthoracic fine needle aspiration of the lung:Cytological subclassification of bronchogenic carcinomas and diagnosis of tuberculosis. Singapore Med J. 2002;43:570-5.
Orell SR, Sterett GF, Walters MN-I, Whitaker D: Manual andAtlas of Fine Needle Aspiration Cytology, 3rd ed. Edinburgh,Churchill Livingstone. 1999.
Santambrogio L, Nosotti M, Bellaviti N, Pavoni G, RadiceF, Caputo V. CT-guided fine-needle aspiration cytology of solitary pulmonary nodules: a prospective, randomized study of immediate cytologic evaluation. Chest. 1997;112:423-5.
Gouliamos AD, Giannopoulos DH, Panagi GM, Fletoridis NK, Deligeorgi-Politi HA, Vlahos LJ. Computed tomography-guided fine needle aspiration of peripheral lung opacities. An Initial Diagnostic Procedure? Acta Cytol. 2000;44:344-8.
Kowalewski J, Sir J, Dancewicz M, Swiniarska J, Pepliński J. Fine needle aspiration biopsy under CT-guidance-usefulness in diagnosis of malignant lung tumors. Pneumonol Alergol Pol. 2004;72:177-80.
Li H, Boiselle PM, Shepard JO, Trotman-Dickenson B, McLoud TC. Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparison of small and large pulmonary nodules. AJR Am J Roentgenol. 1996;167:105-9.
French CA. Respiratory tract. In: Cibas ES, Ducatman BS, editors. Cytology: Diagnostic Principles and Clinical Correlates. 3rd ed. Philadelphia, PA: Saunders. 2009;65-103.
Cristallini EG, Ascani S, Farabi R, Paganelli C, Peciarolo A, Bolis GB. Fine needle aspiration biopsy in the diagnosis of intrathoracic masses. Acta Cytol. 1992;36:416-22.
Damjanov I, linder J. Anderson's Pathology. 10th ed. St. Louis: Mosby. 1996;1.
Wu X, Groves FD, McLaughlin CC, Jemal A, Martin J, Chen VW. Cancer incidence patterns among adolescents and young adults in the United States. Cancer Causes Control. 2005;16:309-20.
Gangopadhyay M, Chakrabarti I, Ghosh N, Giri A. Computed tomography guided fine needle aspiration cytology of mass lesions of lung: Our experience. Indian J Med Paediatr Oncol. 2011;32:192-6.
Bukhari S. J and K tops states in number of smoker. The Hindu Retrived. 2013.
Mukherjee S, Bandyopadhyay G, Bhattacharya A, Ghosh R, Barui G, Karmakar R. Computed tomography-guided fine needle aspiration cytology of solitary pulmonary nodules suspected to be bronchogenic carcinoma: Experience of a general hospital. J Cytol. 2010;27:8-11.
Fassina A, Corradin M, Zardo D, Cappellesso R, Corbetti F, Fassan M. Role and accuracy of rapid on-site evaluation of CT-guided fine needle aspiration cytology of lung nodules. Cytopathology. 2011;22:306-12.
