Abstract
Introduction: The aim of this study was to compare the efficacy of USG guided fine needle aspiration cytology (FNAC) with that of fine needle non aspiration cytology (FNNAC) in abdominal, pelvic masses. Objectives: Although a large volume of data is available to compare FNAC and FNNAC sampling in superficial lesions, very less literature is available regarding FNNAC for abdominal and pelvic masses. Therefore we have directly compared the diagnostic accuracy and specimen quality of both techniques FNAC and FNNAC under guidance of ultrasound in intra abdominal and pelvic mass lesions. Method: Samples were obtained by applying both FNAC and FNNAC techniques for abdominal, pelvic lumps of 71 patients who attended the pathology department of BRD Medical College Gorakhpur, Uttar Pradesh. The sampling procedure were done by single operator, smears made from FNAC and FNNAC techniques were studied using a objective scoring system based on the background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture and then comparison of diagnosed case was done with histopathology. Results: The overall diagnostic accuracy was 85.9% in FNAC and 83.0% in FNNAC(p=0.80).Diagnostic accuracy by FNAC are 83.3%,92.8%,91.6% in cases of liver,gallbladder and ovary respectively. In cases of G.I.T masses it is 81.9% by FNAC.Diagnostic accuracy by FNNAC it is maximum 93.4% in cases of liver masses and lower in ovarian masses (66.6%) when compared with the histopathology. A statistically insignificant difference was recorded in sampling technique score for quality of smears in all cases except in the liver where the FNNAC score was statistically significant. Conclusion: Although both techniques have their own advantages and disadvantages but diagnostic accuracy was much better by FNAC than FNNAC but quality of smears for cytodiagnosis was superior by FNNAC technique than FNAC in all abdominal, pelvic masses.
Highlights
The aim of this study was to compare the efficacy of USG guided fine needle aspiration cytology (FNAC) with that of fine needle non aspiration cytology (FNNAC) in abdominal, pelvic masses
FNAC is more traumatic than non aspiration technique it is thought to, more amount of material is obtained than non aspiration method [2]
After proper work up including detailed clinical history, examination and their routine investigations, provisional diagnosis was made, before they were subjected for non- aspiration and aspiration techniques for rapid cytodiagnosis in every case. patients were excluded from the study if they had severe coagulopathy( international normalized ratio [INR] >2 ) or if there is any physical encumbrance for doing procedure such as a vascular structure obstructing the path of needle.Fine needle non aspiration cytology (FNNAC) was done under ultrasonographic guidance in the presence of a qualified radiologist with the help of 22-24 gauge spinal needle without a syringe and it was followed by fine needle aspiration cytology (FNAC) with 22 gauge spinal needle attached to 20 ml syringe
Summary
The aim of this study was to compare the efficacy of USG guided fine needle aspiration cytology (FNAC) with that of fine needle non aspiration cytology (FNNAC) in abdominal, pelvic masses. We have directly compared the diagnostic accuracy and specimen quality of both techniques FNAC and FNNAC under guidance of ultrasound in intra abdominal and pelvic mass lesions. Manuscript received: 28th October 2018 Reviewed: 07th November 2018 Author Corrected: 14th November 2018 Accepted for Publication: 20th November 2018 This technique was introduced in 1960, because of the limited use of fine needle non aspiration method in cases of sclerotic lesion, deep and small lesions. The present study was performed to compare diagnostic accuracy and specimen quality of ultrasound guided FNAC and FNNAC sampling techniques in intraabdominal and pelvic masses.
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