Transthoracic ultrasound guided fine needle aspiration cytology of peripheral lung lesions: an experience of a pulmonologist
Keywords:Malignancy, Tuberculosis, USG guided Fine needle aspiration cytology.
Background: Ultrasound (USG) guided fine needle aspiration cytology (FNAC) is a simple and cost-effective method for the diagnosis of various peripheral lung lesions. Being radiation free and easily available in most of centres, it has become an important diagnostic modality for early diagnosis of peripheral lung lesions. Besides procedure is simple and complications if occur, can be managed by a pulmonologist effectively. This study was aimed to evaluate the role of Transthoracic ultrasound guided FNAC in diagnosis of peripheral lung lesion.
Methods: This prospective observational study was conducted at Government Chest Diseases Hospital Srinagar over a period of one year from January 2018-December 2018. 61 patients who fulfilled inclusion criteria were included in this study. After properly explaining the procedure and taking informed consent, USG guided FNAC was done in patients with peripheral lung lesions under local anaesthesia. Radiological and cytological data of enrolled patients was collected prospectively and analysed.
Result: About 61 patients were included in this study comprising of 39 males and 22 females in age range of 17- 90 years. Malignancy was the most common cytological diagnosis (78.57%). while as benign diagnosis was reached in 21.43%. In 8.19% of patients, FNAC was inconclusive. Among the malignant group, adenocarcinoma (47.72%) was most common cytological diagnosis. The overall diagnostic yield of USG guided FNAC in this study was 91.8%.
Conclusion: USG guided FNAC of peripheral lung lesions is a simple procedure with high accuracy and less complication rate which can be performed by a pulmonologist for diagnosis.
Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg. 1930;92:169-8.
Shah S, Shukla K, Patel P. Role of fine needle aspiration cytology in diagnosis of lung tumors – A study of 100 cases. Indian J Pathol Microbiol. 2007;50:56-8.
Chen MF, Luh KT, Yang SP. The solitary pulmonary nodules. J Formosan Med Assoc. 1981;80(1):830-8.
Yu CJ, Yang PC, Chang DB. Evaluation of ultrasonically guided biopsies of mediastinal masses. Chest. 1991;100(2):399-405.
Ahmad M, Afzal S, Saeed W, Mubarik A, Saleem N, Khan SA, et al. Efficacy of bronchial wash cytology and its correlation with biopsy in lung tumors. J Pak Med Assoc. 2004;54:13-6.
Sonnenberg VE, Casola G, Ho M. Difficult thoracic lesions: CT-guided biopsy experience in 150 cases. Radiol. 1988; 167(2):457-61.
Nachiappan M, Banerjee A, Rao SK. Role of fine needle aspiration cytology in the management of thoracic lesions. ANZ J Surg. 1990;60(1):31-33.
Senthilvelmurugan V, Premalatha A. Ultrasonogram– guided fine needle aspiration cytology in mediastinum and lung lesions. J Evolution Med Dent Sci. 2016;5(84):6282-6.
Srivastava S, Bajaj S. Ultrasonogram-guided fine needle aspiration cytology in peripheral lung lesions. Int J Contemp Med Surg Radiol. 2018;3(1):60-64.
Clee MD, Duguid HL, Sinclair DJ. Accuracy of morphological diagnosis of lung cancer in a department of respiratory medicine. J Clin Pathol. 1982;35:414-9.
Hollings N, Shaw P. Diagnostic imaging of lung cancer. Eur Respir J. 2002;19:722-42.
Behera D, Balamugesh T. Lung cancer in India. Indian J Chest Dis Allied Sci 2004;46:269-81.
Ahmad M, Afzal S, Saeed W, Mubarik A, Saleem N, Khan SA, et al. Efficacy of bronchial wash cytology and its correlation with biopsy in lung tumours. J Pak Med Assoc 2004;54:13-6.
Dahlstrom JE, Langdale-Smith GM, James DT. Fine needle aspiration cytology of pulmonary lesions: A reliable diagnostic test. Pathology. 2001; 33:13-6.
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.
Madan M, Bannur H. Evaluation of fine needle aspiration cytology in the diagnosis of lung lesions. Turk J Pathol. 2010; 26:1-6.
Tan KB, Thamboo TP, Wang SC, Nilsson B, Rajwanshi A, Salto-Tellez M. Audit of transthoracic fine needle aspiration of the lung: Cytological sub classification of bronchogenic carcinomas and diagnosis of tuberculosis. Singapore Med J. 2002;43:570-5.
Pathak AK, Bhutani M, Mohan A, Guleria R, Bal S, Kochupillai V. Non small cell lung cancer: Current status and future prospects. Indian J Chest Dis Allied Sci. 2004;46:191-20
Shailja S, Sunita B. Ultrasonogram-guided fine needle aspiration cytology in peripheral lung lesions. Int J of Contemporary Med Surg Radiol. 2018;3(1):60-64.
Bandyopadhyay A, Laha R, Das TK, Sen S, Mangal S, Mitra PK. CT guided fine needle aspiration cytology of thoracic mass lesions: a prospective study of immediate cytological evaluation. Indian J Pathol Microbiol. 2007;50(1):51-5.
JunpeiIkezoe, Morimonto S, Arisawa J Takashima S, Kozuka T, Nakahara K. Percutaneous biopsy of thoracic lesions: Value of sonograpy for needle guidance. AJR. 1990 154(4):1181-85.
Pant AG. Ultrasonographically guided fine needle aspiration biopsy of intrathoracic tumors. IJR. 1991; 23-26.
Chen C, Charg C. Guided core biopsy of lung lesions. Am. J Roentgenol. 2009:193(3):1228-1235
Modini VR, Sudheer BD, Rajendra KK, Surya KP, Juvva KS. Ultrasound guided transthoracic fine needle aspiration cytology in diagnosing peripheral pulmonary lesions. J Evol Med Dental Sci. 2015;4(44):7610-6.
Knudsen. Ultrasonographically guided fine-needle aspiration biopsy of intrathoracic tumors. Acta Radiol. 1996;37(3 Pt 1):327-31.
Sinner WN. Pulmonary neoplasms diagnosed with transthoracic needle biopsy. Lancet. 1979;43(4): 1533-40.