Role of core-needle biopsies in cases of mediastinal mass lesions as a primary diagnostic modality in comparison with fine-needle aspiration cytology

Abstract

Introduction: The spectrum of mediastinal masses comprises of lesions of various origins. Although the clinicoradiological findings and the location of these lesions within different mediastinal compartments help narrow down the differentials, tissue diagnosis remains the gold standard for diagnosis. The image-guided percutaneous transthoracic fine-needle aspiration cytology (FNAC) and/or core-needle biopsy (CNB) of the mediastinal lesions are considered to be cost-effective and safe diagnostic procedures. CNB of mediastinal lesions is found to provide better yield with the accuracy of 75%–90% and is more precise as compared to FNAC. In this article, we study the role of CNB in cases of mediastinal masses as a primary diagnostic modality as compared to FNAC. Materials and Methods: A retrospective observational study was conducted at a tertiary care hospital in Mumbai. All cases with mediastinal mass lesions diagnosed by FNAC and/or CNB over a period of 1 year in a tertiary care hospital were analyzed. Cases were divided into FNAC group or CNB group depending on the primary diagnostic procedure undertaken. Comparisons were made between the two groups. Results: CNB group was found to have better diagnostic yield in benign as well as malignant lesions in comparison with the FNAC group. The time taken to reach the definitive diagnosis was found to be shorter in the CNB group as compared to the FNAC group. Conclusion: The use of CNB as a primary diagnostic modality may provide faster and accurate tissue diagnosis in cases of mediastinal masses of both benign and malignant nature as compared to FNAC.