Pulmonary Mass Lesions: CT Scan Diagnostic-Impressions and FNAC Diagnoses – A Correlative Study

Abstract

Introduction: Bronchogenic carcinoma, the commonest pulmonary mass lesion, is the leading cause of cancer related death globally. Computed tomography (CT) scan is often used for evaluation of pulmonary mass lesions to have an initial diagnostic impression for deciding on next course of actions in clinical management. So, it becomes highly imperative to study the correlation of CT scan-diagnoses with pathological diagnoses. Till date such correlative studies are very meagre from north-eastern part of India. This study was designed to address this deficiency. Aim: To correlate CT scan-diagnoses of pulmonary mass lesions with the pathological diagnoses made on fine needle aspiration cytology (FNAC). Materials and Methods: Ninety subjects with pulmonary mass lesions were included. CT scan evaluation and CT-guided FNAC were performed. Important clinical profiles, radiological diagnostic impressions on nature of the lesions (malignant/benign) and cytological diagnoses were recorded. Finally, a radio-cytological correlation of diagnoses was done. Results: Out of 90 cases, CT scans diagnosed 81 cases as malignant and nine as benign. On FNAC, there were 73 malignant and nine benign lesions and in eight cases aspirates were unsatisfactory. An overall radio-cytological correlation of 92.6% was observed. The sensitivity and specificity of CT scan for detecting malignancy in pulmonary mass lesions were found to be 94.5% and 55.5% respectively with an overall diagnostic accuracy of 89%. Conclusion: CT scan study is a very useful non-invasive diagnostic modality in the clinical evaluation of lung masses. CT-guided FNAC is a simple, rapid and safe procedure with high yielding rate of pathological diagnoses.