Percutaneous Fine Needle Aspiration Cytology Research Articles

Study on Computed Tomography (CT) Guided Transthoracic Fine Needle Aspiration Cytology (FNAC) in the Diagnosis of Intrathoracic Mass Lesions - Not Approachable by USG

Background: Intrathoracic mass is a general issue encountered by the physicians in whole world including Bangladesh. Accurate diagnosis is important for proper management. Percutaneous fine needle aspiration cytology (FNAC) has been extensively utilized and widely accepted as an important means of diagnostic technique. This study was performed to know and justify the computed tomography (CT) guided FNAC as a diagnostic modality for the diagnosis of intrathoracic masses which are non-approachable by ultrasonography (USG). Methods: It was a descriptive type of cross sectional study and conducted among 30 patients having ultrasonologically non approachable intrathoracic masses during the period of Feb 2016 to July 2016 in Combined Military Hospital (CMH), Dhaka considering selection criteria and informed written consent using purposive sampling technique. FNAC was done in all the patients. After further investigation, a definitive diagnosis was made. The analysis of the surgical specimen, the biopsy, the therapeutic response, and the clinical follow-up all contributed to the ultimate diagnosis. A comparison was done between the cytological and final diagnosis for thirty cases. Ethical issues were properly addressed. Results: Initially CT guided FNAC was carried out on all patients. Conclusive cytological diagnosis was possible in 28 patients yielding 93.33% diagnostic accuracy. FNAC diagnosed 24 cases as malignant intrathoracic mass, 04 as benign lesion and 02 undiagnosed due to inadequate tissue material. In final diagnosis 25(75%) diagnosed as malignant and 05(25%) diagnosed as benign. Diagnosis of two patients was impossible by FNAC due to inadequate tissue material. Conclusion: CT guided FNAC of intrathoracic mass allow early diagnosis with lesser trauma and lower cost. This procedure avoided more invasive diagnostic surgery. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 10-16

Role of Ultrasound Guided Fine Needle Aspiration Cytology in Intra-abdominal lesion

Introduction: All of the imaging techniques have advantages and disadvantage in various parts of the body. In intraabdominal lesion ultrasonography guided FNAC has advantage over computerised tomography guided FNAC because CT is very costly and not freely available. CT gives high dose of radiation and therefore should not be used in pregnant women and in small children whereas ultrasonography has no radiation effects and hence can be safely used in these cases. Mobile version of CT is not available and therefore it cannot be used in faraway places whereas ultrasonography machine is mobile. Thus, with localization by ultrasonography diagnosis of the malignancy and staging can be accomplished through FNAC. Method: Total of 100 cases who came for FNAC of intraabdominal masseswere included in the study, irrespective of their age, sex or possible nature of mass. Ultrasound guided Fine needle aspiration was done in all.The aim of the present study was to assess the feasibility of ultrasound guided Fine needle aspiration cytology of routine procedure for detection of abdominal lesion. Result: Total of 100 cases were studied. In the 80(80%) cases, aspirates were positive for malignancy and in 17(17%) cases were negative for malignancy. There were 3% false negative cases encountered. There were no false positive cases. Ultrasound was used for mass localization. In 80 positive cases of malignancy, 36 cases from liver, 10 from lymph node, 7 from gall bladder, 6 from stomach, 6 from ovary, 3 from urinary bladder, 1 from pancreas, I from uterus, 3 from miscellaneous sites. Conclusion: Percutaneous fine needle aspiration cytology is reliable method of diagnosing the various pathological lesions of abdomen. Its diagnostic accuracy is further increased when performed under Radiological guidance. Of all modalities of guidance at present is the most suitable.

Accuracy of Perineal Percutaneous Fine Needle Aspiration Cytology (FNAC) of Prostate under Ultra- Sound in Comparism with Transrectal Aspiration in Diagnosis of Prostatic Cancer

Background: Prostatic carcinoma is the commonest internal malignancy of adult males. Patients usually presenting withvoiding symptoms. Clinical suspicion of prostatic carcinoma depends on finding of one or more of the followings; hard prostaticnodule(s) on digital rectal examination (DRE), hypoechoic lesion on transrectal ultrasonography (TRUS), and/or highserum level of prostatic specific antigen (PSA). Final diagnosis depends on FNAC and/or histopathology. Objective: This is acase control prospective study designed to evaluate the usefulness of FNAC of prostate through perineal skin under ultrasoundinstead of transrectal aspiration in diagnosis of suspicious prostatic conditions.Patients and Methods: One hundred and ten males with voiding symptoms and clinical suspicion of prostatic carcinoma wereparticipated in the study. Their ages were between 45 and 92 years. The aspiration was carried out as outpatient procedure.Results: Cytopathological results were; 64 (58.18%) positive, 4 (3.64%) suspicious, and 40 (36.36%) negative for prostaticcancer. Two specimens (1.82%) were inadequate for proper cytopathology. Results of histopathological examination of resectedspecimens from the same patients was very close to that of cytopathology with only two false positive and one falsenegative results. There was no any mentioned complication following aspiration, and sensitivity, specificity, and accuracywere 98%, 95%, and 91.81% respectively, and all results were statistically significant with p-values <0.05.Conclusion: Percutaneous perineal FNAC of prostate under ultrasound is a safe, reliable, cost effective, and as accurate astransrectal FNAC in diagnosis of prostatic cancer.Keywords: Perineal prostatic FNAC, Prostatic Cytopathology, PSA, TRUS.

Evaluation of Computed Tomography Guided Percutaneous Fine Needle Aspiration Cytology in the Diagnosis of Lung Lesions

Evaluation of Computed Tomography Guided Percutaneous Fine Needle Aspiration Cytology in the Diagnosis of Lung Lesions

A study of relative value of percutaneous fine needle aspiration cytology and bronchoscopy in pulmonary lesions

Percutaneous fine needle aspiration cytology (FNAC) is a useful additional method for establishing a diagnosis of intrathoracic lesions without a thoracotomy. Aims and Objective: To study the comparative role of FNAC. 1) In establishing the diagnosis of intrathoracic solid lesions. 2) Its role in improving the diagnostic yield. Material and Methods: All the patients, irrespective of their age and sex, who presented with space occupying lesions in thorax, large nodular shadows and consolidation on clinico-radiological ground, were included in the study and subjected to FNAC and other procedures like fiberoptic bronchoscopy (FOB) etc. Results: 44 patients were enrolled in the study. 56.8% cases were diagnosed as primary carcinoma lung and 6.8% as benign lesions, while 36.4% cases could not be diagnosed by any means. 28 cases were diagnosed either by means of FNAC and / or by other methods of investigation like FOB and sputum cytology. Overall diagnostic yield of FNAC was 54.5%, with positivity more in central lesions (66.7%) than in peripheral lesions (46.2%). Diagnostic yield of FNAC for malignancy was 84%. Overall diagnostic yield by bronchoscopy was 17/44(38.6%). FNAC was also effective to pick up diagnosis in 13(29.5%) but failed in 4 cases which were diagnosed by bronchoscopy. Overall 6.8% patients developed minor complications. Conclusion: Considering its simplicity, safety, rapidity, cost effective and high diagnostic accuracy FNAC can be and should be performed as an initial diagnostic measure, preceding bronchoscopy, mediastinoscopy and thoracotomy whenever exfoliative sputum cytology has failed to establish the diagnosis of the entire peripheral and selected intrathoracic lesion.

Percutaneous ultrasound-guided fine needle aspiration cytology of pulmonary lesions: a single centre experience

Purpose: Imaging-guided percutaneous fine needle aspiration biopsy (FNAB) is routinely used for the diagnosis of pulmonary lesions. Computed tomography (CT) is the most common imaging modality used for guidance followed by ultrasound (US).

Sclerosing Perivascular Epithelioid Cell Tumor of the Lung: A Case Report with Cytologic Findings.

Benign perivascular epithelioid cell tumor (PEComa) of the lung is a rare benign neoplasm, a sclerosing variant of which is even rarer. We present a case of 51-year-old man who was diagnosed with benign sclerosing PEComa by percutaneous fine needle aspiration cytology and biopsy. The aspirate revealed a few cell clusters composed of bland-looking polygonal or spindle cells with fine granular or clear cytoplasm. Occasional fine vessel-like structures with surrounding hyalinized materials were seen. The patient later underwent wedge resection of the lung. The histopathological study of the resected specimen revealed sheets of polygonal cells with clear vacuolated cytoplasm, variably sized thin blood vessels, and densely hyalinized stroma. In immunohistochemical studies, reactivity of tumor cells for human melanoma black 45 and Melan-A further supported the diagnosis of benign sclerosing PEComa. To the best of our knowledge, this is the first case of benign sclerosing PEComa described in lung.

Evaluation of Ultrasound Guided Fine Needle Aspiration Cytology for Diagnosing Lung Lesions – A 3-Year Study

Fine needle aspiration cytology (FNAC) especially ultrasound guided has a very important role in diagnosing pulmonary lesions. The present study was undertaken to evaluate the diagnostic efficacy of image-guided percutaneous fine needle aspiration cytology in various lung lesions. This is a three-year retrospective study from August 2010 to July 2013. A total of 322 cases were included in the study. The clinical, radiological and cytological data of all 322 cases who underwent ultrasound guided FNAC were studied. Of the 322 cases in our study, malignancy was the predominant lesion found in 192 cases (59.62%) followed by inflammatory pathology 23 cases (7.1%). Among the malignant lesions, adenocarcinoma was the most common malignancy (26.56%) in females and males followed by squamous cell carcinoma (23.95%). Over the three-year period of the study, 92 cases were grouped under non-specific lesions/inadequate for interpretation. Percutaneous ultrasound-guided FNAC is a relatively safe and accurate procedure in the diagnosis of lung lesion especially peripheral lung lesions.

Clinical audit of ultrasound guided fine needle aspiration in a general cytopathology service.

Background:Studies on ultrasonography (USG) guided fine needle aspiration cytology (FNAC) have been conducted in specialized settings such as thyroid, breast, and intra-abdominal aspirates. There is a paucity of literature on the practices of guided FNAC in a general cytopathology service.Aim:The aim was to determine prevailing practices of USG guided FNAC in a general cytopathology service of a teaching hospital.Settings and Design:Metropolitan hospital, clinical audit.Materials and Methods:Audit of 112 USG guided percutaneous FNAC done over 12 months.Statistical Analysis:Data were coded, entered in an excel spreadsheet and analyzed by translating into percentages and proportions.Results:The 112 guided FNACs included constituted 36 thyroid (32.14%), 45 intra-abdominal (40.17%), 11 breast (9.82%), 10 superficial lymph node (8.92%) and 10 soft tissue and miscellaneous (8.92%) lesions. Previous freehand FNAC was documented on the requisition forms in 14 cases. The reports were: Inadequate 33 (29.46%), nondiagnostic descriptive 35 (31.25%) or diagnostic 44 (39.28%). Inadequacy rates of aspirates from thyroid were 11 (30.56%) breast were 2 (18.18%), and intra-abdominal lesions were 13 (28.88%). Majority of the reports were nonstructured: 108 (96.42%) and nonrecommendatory: 101 (90.17%).Conclusions:Reporting practices varied and did not conform to a uniform structure. The inadequacy rates of breast and thyroid aspirates were comparable to the rates in the literature. Comparable studies were not available for intra-abdominal aspirates.

English

Computed tomography guided percutaneous transthoracic fine needle aspiration cytology (FNAC) of thoracic lesions is a widely accepted, simple, rapid, safe and accurate diagnostic tool of relatively low cost. OBJECTIVE: The aim of this study was to evaluate the diagnostic value of the noninvasive method of CT-guided needle aspiration cytology in the assessment of radiologically detected intra thoracic mass lesions, to analyze the results and to know the pathological spectrum of thoracic masses (both benign and malignant) along with the correlation of CT findings with cytopathological reports. SETTINGS AND DESIGN: We conducted an institution based prospective study on patients who presented with thoracic mass lesions in lungs, mediastinum, hilar lymph nodes, thoracic vertebrae, paraspinal soft tissues and pleura. Cytologic examination was performed on site after staining smears with the Hematoxylin and eosin method. It was possible to define the cytologic lineage in 94 percent of the cases and in 3 cases (5.4 percent) the material was insufficient for the cytologic diagnosis. The diagnostic accuracy of percutaneous transthoracic fine needle aspiration cytology was more than 90%.Out of 52 cases, 11 cases were non-neoplastic while 41 cases were neoplastic. Among the non-neoplastic lesions, specific diagnosis were obtained in 10 cases. The diagnostic sensitivity of malignancy was 92.5% and specificity was 100%, positive predictive value of 100 percent and negative of 80 percent. Male to female ratio was 2.9:1. Majority of cases was seen in 5 th to 6 th decade. The most common tumor was squamous cell carcinoma (44.82%) followed by adenocarcinoma (31.03%) Post procedural complications were few. CONCLUSIONS: This study showed that FNAC, under computed tomography guidance, is a simple, rapid, safe, sensitive and specific technique procedure with insignificant rate of complications for the diagnosis of thoracic lesions. It can be used as a first line of investigation and also helps in deciding on appropriate

Impact of image guided fine needle aspiration cytology in diagnosis of pediatric hepatic mass and cytohistologic concordance.

Background:Pediatric hepatic mass is a heterogeneous group of benign and malignant lesions. Percutaneous fine needle aspiration cytology (FNAC) can be utilized as a diagnostic modality to assess the nature of radiologically demonstrated hepatic lesions and thus facilitate individualized treatment.Aims and Objective:The objective of the present study was to determine the diagnostic accuracy of percutaneous FNAC of pediatric liver masses, a procedure that is less invasive than open biopsy.Materials and Methods:A prospective, observational study was carried out in the Department of Pathology in collaboration with Department of Pediatric surgery and Radio-diagnosis including 31 pediatric patients presenting over last two years (June 2011 to May 2013) with focal hepatic lesion on ultrasound and computed tomography (CT) scan. FNAC was carried out under image guidance and cytodiagnosis was reached after appropriate staining. By comparing with histopathology reports, diagnostic accuracy of cytology was evaluated.Result:Among 31 cases included in the study, 51.6% cases were cytologically benign and hemangioma was the most common benign lesion. Hepatoblastoma was the most accounted malignant tumour (12.9%). FNAC provided 94% sensitivity and 92% specificity in diagnosing benign and malignant tumours. Overall diagnostic accuracy was 93.10%. No significant complication was noted.Conclusion:Percutaneous FNAC under image guidance is an effective diagnostic tool for diagnosis of primary and metastatic tumours of liver in pediatric patients.

Computed tomography guided fine needle aspiration cytology of pulmonary mass lesions in a tertiary care hospital: A two-year prospective study

Background: Percutaneous or transthoracic fine needle aspiration cytology (FNAC) is a rapidly emerging diagnostic modality to assess the nature of radiologically demonstrated lung lesions. Aims: The present study was conducted to evaluate the usefulness of computed tomography (CT)-guided FNAC in the diagnosis of pulmonary mass lesions. Materials and Methods: The present prospective study was carried out on 74 cases of radiologically diagnosed pulmonary mass lesions involving the periphery of the lung parenchyma with strong clinical suspicion of pulmonary neoplasm. CT-guided transthoracic fine needle aspiration was performed and cytology smears were stained with May-Grόnwald-Giemsa (MGG) stain and conventional Papanicolaou (Pap) stain. Smears were broadly categorized into unsatisfactory, benign, suspicious of malignancy and malignant lesion. The cytological diagnosis was compared with subsequent histopathology report where it was necessary. Results: A total of 74 cases of pulmonary mass lesions were included in the present study, of which 58 were males (78.4%). The mean age of the patients was 51.6 years, but the mean age in case of malignant lesions was 62.5 years. Cough was the most common respiratory symptoms (100%) followed by weight loss (91.9%) and fever (62.2%). Maximum cases of benign lesions were chronic non-specific inflammation (10.8%; 8 cases) followed by tuberculosis (8.1%). Regarding the malignant categories, non-small cell carcinoma, not otherwise specified (NOS) (13.5%; 10 cases) was the most common malignancy followed by adenocarcinoma (10.8%; 8 cases), small cell carcinoma (8.1%; 6 cases) and squamous cell carcinoma (6.7%, 5 cases) respectively. All the 38 cases of malignant lesions were confirmed by histopathology. Out of 10 cases of non-small cell carcinoma, NOS 4 cases were diagnosed histopathologically as poorly differentiated adenocarcinoma, 2 cases as high grade squamous cell carcinoma, 2 cases as large cell carcinoma, 1 case as pleomorphic carcinoma and 1 case as adenosquamous carcinoma. Conclusion: CT guided FNAC is a less expensive, simple, fast and reliable method for diagnosis of pulmonary mass lesions.

Computed tomography guided percutaneous transthoracic fine needle aspiration cytology of pulmonary mass lesions: Two years cross sectional study of 61 cases

Background and Objective: A vast spectrum of pathological lesions like neoplastic, inflammatory, congenital and various miscellaneous lesions may present as lung masses. With computed tomography (CT) guidance it is possible to perform a biopsy on almost any portion of lung with high degree of safety and minimal morbidity avoiding more invasive techniques. The objective of present study was to evaluate the diagnostic utility of CT-guided fine needle aspiration cytology (FNAC) in pulmonary mass lesions and to compare with previous similar studies. Materials and Methods: Sixty-one patients presented with undiagnosed pulmonary mass lesions underwent CT-guided FNAC for a period of 18 months. The lesions were localized by CT scan and after the needle tip was confirmed to be in the desired location, aspirations were performed. Smears were fixed with 95% ethyl alcohol stained for Papanicolaou stain and air dried smears were routinely stained with giemsa. Cell blocks were prepared from aspirated materials. Data were analyzed using Epi Info™ version 7. Results: Out of 61 one cases, 56 (91.80%) cases were adequate for evaluation. Considering cell block diagnosis as the standard, sensitivity, specificity, positive predictive value and negative predictive value and diagnostic accuracy of CT-guided FNAC of pulmonary malignant lesions were 95.5%, 84.6%, 94.3%, 91.3% and 91.6% respectively (P < 0.0000096). The mean age of presentation was 65.75 years with male to female ratio of 1.44:1. Squamous cell carcinoma was the most common malignant lesion (35.0%). Hemoptysis and transient pleuritic chest pain were some complications encountered. Conclusion: CT-guided FNAC is simple, safe and has a high sensitivity and diagnostic accuracy with only a few complications.

CT-Guided Percutaneous Fine Needle Aspiration Cytology of Pulmonary Mass.

Introduction: Following the first study of Computed tomography guided trans thoracic biopsy of lung lesion by Haaga and Alfidi in 1976, CT guided transthoracic biopsy has been widely used for confirming the diagnosis of suspicious lung lesions. This study is aimed to assess the effectiveness of Transthoracic percutaneous fi ne needle aspiration cytology and frequency of associated complications. Methods: A retrospective, hospital based study was performed between 11/06/2008 and 1/12/2009 at Department of Radiology, Shree Birendra Hospital, Kathmandu, Nepal. Thirty nine consecutive cases of lung lesions who underwent Trans Thoracic Percutaneous Fine Needle Aspiration Cytology (TTFNAC) under CT guidance were analysed. Smears of the aspirated material were evaluated by the pathology consultant (cytopathological evaluation) for adequacy. Results: There was adequate material for a cytopathological diagnosis in thirty four (87.18 %) cases. Two cases were hemorrhagic while three cases revealed only reactive cells thus inadequate and non representative case constituted (12.8 %). Eight cases were reported as benign (23.53 %). Twenty three samples (67.65%) were reported as definite malignant cases and three cases (8.82%) showed atypical cells, suggestive of malignancy. Squamous cell carcinoma was the single most frequent histological diagnosis (12 cases). Conclusions: The FNAC of lung is useful, safe and economical technique providing 87% diagnostic accuracy for lung mass without significant increase in complications. Medical Journal of Shree Birendra Hospital; Jan-June 2012/vol.11/Issue1/37-41 DOI: http://dx.doi.org/10.3126/mjsbh.v11i1.7766

Primary mucosa-associated lymphoid tissue lymphoma as a pleural mass

Primary pleural lymphoma is a rare entity that has been described in association with human immunodeficiency virus (HIV) infection or pyothorax. It occurs in only 7% of primary lymphoma cases. We report the case of a 52-year-old male with no history of HIV infection or pyothorax who was diagnosed of obstructive sleep apnoea syndrome (OSAS) and underwent a routine chest X-ray to screen for any organic cause of the symptoms. The radiograph revealed two voluminous masses with extraparenchymatous features but without pleural effusion. A contrast-enhanced CT was performed and confirmed the existence of the pleural masses that showed homogeneous attenuation. Neither mediastinal lymphadenopathy nor pleural effusion were present. A percutaneous CT-guided fine needle aspiration cytology (FNAC) with a 25-G needle was performed (two samples were obtained) and the first diagnosis was of non-Hodgkin's lymphoma. The final diagnosis of primary pleural mucosa-associated lymphoid tissue (MALT) lymphoma was confirmed by a CT-guided core biopsy with a 20-G needle. To the best of our knowledge, no cases of MALT lymphoma presenting as pleural masses without pleural effusion have been reported in immunocompetent patients. In this report, we describe the case of a patient with a primary pleural MALT lymphoma and include a short review of the literature.

Hepatobiliary cystadenomas and cystadenocarcinomas: a report of 33 cases

Hepatobiliary cystadenomas and cystadenocarcinomas are rare and often misdiagnosed. We report our experience with 33 cases over 20 years to discuss an algorithm for these diseases. Patients presenting with a diagnosis of hepatobiliary cystadenomas and cystadenocarcinomas were retrospectively reviewed from January 1991 to October 2010. Clinical data were collected by examining hospital records and by follow-up questionnaire interviews. Thirty-three patients had pathologically diagnosed hepatobiliary cystadenomas (19/33, 17 females and two males) or cystadenocarcinomas (14/33, five females and nine males). Symptoms of cystadenomas at hospitalization were abdominal bloating or pain (9/19). Nine patients had an elevated level of carbohydrate antigen (CA) 19-9. The surgical procedures, i.e. cyst enucleation, segmentectomy, sectionectomy and hemihepatectomy, were performed with satisfactory outcomes. Symptoms of cystadenocarcinomas included abdominal bloating or pain (8/14) and fever (3/14). Seven patients had elevated CA19-9. The imaging characteristics of cystadenocarcinomas were similar to those of cystadenomas. The clinical outcomes for cystadenocarcinomas were mostly poor after either surgical or conservative treatment. Clinical symptoms are unreliable for these diagnoses and their differential diagnosis. Imaging evaluations and CA19-9 are of value for the recognition of cystadenoma and cystadenocarcinoma, but not for their differential diagnosis. Any recurrence of liver cyst after surgery or other treatments should lead one to suspect one of these diseases. Invasive examination and percutaneous fine-needle aspiration cytology are not recommended. Complete excision or careful enucleation should be the first treatment choice for a better prognosis.

Capillary Hemangioma Mimicking a Dumbbell-Shaped Mediastinal Neurinoma

A 57-year-old woman was admitted to our hospital complaining distal hypoesthesia and progressive paraparesis in both legs. A chest computed tomography scan showed a 4 × 3 cm, well-defined, and homogeneously enhancing mass in the posterior left paraspinal region (Fig 1A, arrow). Magnetic resonance imaging demonstrated that the mass entered into spinal canal from the intervertebral foramen between T3 and T4, compressing the spinal cord (Fig 1B, arrow). Percutaneous fine-needle aspiration cytology, performed under computed tomography guidance, was not diagnostic.

Value of ultrasonography-guided fine needle aspiration cytology in the investigative sequence of hepatic lesions with an emphasis on hepatocellular carcinoma

Background:The evaluation and management of various hepatic lesions is a common clinical problem and their appropriate clinical management depends on accurate diagnoses.Aims:To study the cytomorphological features of distinctive non-neoplastic and neoplastic lesions of the liver and to evaluate the sensitivity, specificity and diagnostic accuracy of ultrasonography (USG)-guided fine needle aspiration cytology (FNAC) in the diagnosis of liver diseases.Materials and Methods:Seventy-two patients with evidence of liver diseases underwent USG-guided, percutaneous FNAC. Cytomorphological diagnoses were correlated with clinical, biochemical and radiological findings, histopathological diagnoses and follow-up information.Results:The age of the patients ranged from eight months to 90 years with 48 males (66.67%) and 24 females (33.33%). Of the 72 cases, the cytological diagnosis was rendered in 71 patients and smears were inadequate for interpretation in one case. Neoplastic lesions (68.06%) were more common than non-neoplastic lesions (30.56%). The majority of the neoplastic lesions were hepatocellular carcinomas (36.12%) followed by metastatic adenocarcinomas (19.45%). Among non-neoplastic lesions, cirrhosis was the commonest lesion (8.34%). The overall diagnostic accuracy of FNAC was 97.82% with a sensitivity and specificity of 96.87 and 100% respectively.Conclusion:USG-guided FNAC of the liver is a safe, simple, cost-effective and accurate method for cytological diagnosis of hepatic diffuse, focal/nodular and cystic lesions with good sensitivity and specificity.

The application of cytogenetics and fluorescence in situ hybridization to fine‐needle aspiration in the diagnosis and subclassification of renal neoplasms

Percutaneous fine-needle aspiration (FNA) cytology is an important diagnostic test for the evaluation and management of selected renal masses. Cytogenetic analysis of cytology specimens can serve as an adjunct for precise classification because certain tumors are associated with specific chromosomal aberrations. This study summarizes our experience with the application of conventional cytogenetics and fluorescence in situ hybridization (FISH) to renal FNA specimens. All percutaneous renal FNAs performed during 2005 through 2008 were identified from the electronic pathology database. Results of cytogenetic and FISH analyses were correlated with the final diagnoses of the renal FNAs. A total of 303 renal FNAs were performed. During an onsite assessment, a portion of the cytology specimen was allocated for cytogenetic analysis in 74 cases. Karyotypic analysis or FISH was successful in 44 (59%) of these. Characteristic chromosomal abnormalities were observed in 27 cases. In 17 cases, a karyotype revealed a combination of trisomies/tetrasomies and in another 5 cases, FISH revealed trisomy 7 and 17, both of which are consistent with papillary renal cell carcinoma (RCC). Two cases showed 3p deletions consistent with clear cell RCC. Trisomy 3 was observed in 1 case of clear cell RCC. Monosomy 1 and 17 was observed in a case of papillary RCC comprised oncocytic cells. In 1 case of primary renal synovial sarcoma, FISH revealed a rearrangement at the SYT locus (18q11.2). Renal FNA specimens are amenable to analysis by cytogenetics and FISH in the diagnosis and subclassification of renal neoplasms.

Usefulness CT-guided F.N.A.C. in the Diagnosis of Mediastinal Lesions

Objective To evaluate the diagnostic accuracy of the percutaneous fine needle aspiration cytology (FNAC) for mediastinal lesions by using histology or follow-up clinical diagnosis as gold standard. Patients and Methods CT-guided percutaneous FNAC was performed on 131 patients with mediastinal lesions. Helical CT was used with 3–10mm image thickness range and low radiation dose (40mAs, 120kV). Samples were immediately examined by a cytologist to determine if they were representative. Histological samples were obtained by means of biopsy or resection specimens in 73 patients and clinical follow-up in 50. Results The material was satisfactory for diagnosis in 126 patients (95.2 %), in whom 103 lesions (78.6%) were considered malignant (62 primary tumours and 41 metastases) and 23 (17.6%) benign. In the 123 patients with clinical monitoring or pathological diagnosis, using FNAC led to the identification of malignancy with a sensitivity of 95.2 % (95%CI: 89.2–97.9%), specificity 84.2% (95%CI: 62.4–94.5%), positive predictive value 97.1% (95%-CI: 91.7–99.0%), negative predictive value 76.2% (95%CI: 54.9–89.4%), likelihoodratio positive 6.03 (95%CI: 2.13–17.05) and accuracy 93.5% (95%CI: 87.7–96.7%). Pneumothorax was the most frequent complication (3 cases). There was good agreement between the cytological findings and the histological findings, not only for malignant lesions (kappa coefficient: 0.641) but also for benign (kappa 0.607). Conclusions CT-guided percutaneous FNAC is a safe and effective technique for the diagnosis of the mediastinal masses, with a high diagnostic yield for malignancy depicting.