Correlation of fine-needle aspiration cytology and surgical excision in the diagnosis of patients with cancer

Abstract

Background: Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasms. Fine-needle aspiration cytology (FNAC) has been extensively used for many years in the diagnosis of cancers, especially breast cancers, but its use has gradually been reduced in some hospitals because of its controversial inadequate rates and suboptimal accuracy in inexperienced hands and in some cases conflicting reports when compared with the excised biopsy of the same lesion. This is a prospective study to correlate the cytological findings in patients diagnosed with cancer with the histological diagnosis on excision. Materials and Methods: This was a prospective study of 30 patients that attended the Department of Pathology, Federal Medical Centre, Birnin Kebbi, from July 2016 to June 2017. All patients who were diagnosed after FNAC as having a malignant lesion were followed up for surgery for their excision biopsy. FNAC of the 30 patients was performed using 23-gauge needle under direct palpation (27 cases) by the pathologist and by ultrasonographic guidance (3 cases) before the surgical excision. Specimen after excision was fixed in 10% buffered formalin and stained with routine hematoxylin and eosin. Diagnosis on FNAC was subsequently compared with diagnosis after excision. Immunohistochemistry studies using limited antibody panels (CD5, CD10, CD20, CD30, and Bcl-2) were used on some surgical tissues (mostly lymphoid tissues) using Genemed biotechnology protocol to arrive at a definitive diagnosis. Results: A total of 30 patients had FNAC of various cancers during the study period, and all patients had excision biopsy subsequently. The age range was 5–65 years, with the most common sites of FNAC been the breast 17 (56.7%), abdomen 5 (16.5%), and cervical lymph nodes 4 (13.3%). There was 100% concordance between the diagnosis on FNAC and the excised tissues. Conclusion: FNAC correlates very well with histology of the excised tissues and remains a useful tool to guide the clinician for better management of patients.