Diagnstic accuracy of Computed Tomography- guided Fine Needle Aspiration Cytology of thoracic mass lesions-A study of 33 cases

Abstract

Aim: The mediastinum harbors a mixed bag of tumors, which may create significant diagnostic dilemmas. These tumors have widely variable therapeutic and prognostic implications. Correct pre-operative cytological diagnosis and trucut biopsy if indicated, may obviate the need of surgical excision of many of these lesions. A stepwise algorithmic approach such as clinical history, radiological localization, salient cytomorphology and ancillary test helps in correct diagnosis of these tumors. This paper discusses the stepwise diagnostic algorithm for fine needle aspiration cytology diagnosis of mediastinal tumors. Materials and methods: Prospectively thirty-three patients were studied over a year (July 2015 to June 2016) for their age, sex, and topographic distribution, cytological diagnosis and histopathological diagnosis on tru cut biopsy specimen. Thereafterthe diagnosis on the basis of Cytology smears and histological sections were evaluated in all patients. Results: Among 33 patients, 27 were male and 6 were female. Most mediastinal neoplasm was identified in 3 rd to fifth decade of life. Lymphoma and Germ cell tumor are the most common Mediastinal neoplasm. Adequate tissue material was obtained in 32 of 33 cases by CNB. Of these 32 patients, 26(78.79%) cases were diagnosed correctly by FNAC, whereas 7(21.21%) cases were not diagnosed definitely by FNAC. The sensitivity of CNB for mediastinal neoplasm was 87.88%, significantly higher than FNAC (78.79 %) (P<0.05). Mediastinum is the common site and tissue diagnoses of mediastinal mass are very important for correct therapeutic decision.