Value Of Fine Needle Aspiration Research Articles

Comparison of the diagnostic value of fine needle aspiration and ultrasound in thyroid pathology

Fine needle aspiration (FNA) biopsy has been a powerful tool in the preoperative diagnosis of thyroid nodules for more than 60 years. The Bethesda scale standardizes the results of cytology and is a tool for interaction between the laboratory and the clinician. At the same time, there is a stratification of ultrasound signs of thyroid lesions according to the TI-RADS scale. In this regard, it became necessary to determine the diagnostic value of ultrasound signs of thyroid lesions, stratified by TI-RADS, in comparison with the results of a biopsy, classified by the Bethesda scale.AIM: a comparative assessment of the results of FNA and ultrasound in determining indications for the surgical treatment of thyroid nodules.MATERIALS AND METHODS: for 2018–2021 in the surgical department of the SCC №2 of the Petrovsky National Research Centre of Surgery, 859 FNA were performed. For comparative analysis, 141 patients who underwent surgery for thyroid nodules were selected. All patients at the preoperative stage underwent FNA with stratification of the results according to the Bethesda scale and ultrasound of the thyroid gland with stratification according to the EU-TI-RADS scale.RESULTS: FNA showed high diagnostic accuracy and sensitivity, preoperative thyroid ultrasound had high specificity, but low sensitivity. The high diagnostic value of FNA was confirmed by statistical analysis of the obtained data (OR 31.29 95% CI 2.20–4.69, RR 13.28 95% CI 1.46–3.71). When analyzing preoperative ultrasound, it was not possible to obtain reliable statistical results (OR 2.99 95% CI 0.34-1.85, RR 1.97 95% CI 0.23-1.12).CONCLUSION: Ultrasound of the thyroid gland cannot replace FNA in thyroid nodules. Biopsy remains the main diagnostic method for nodular goiter. The main objective of TI-RADS-stratified ultrasound is to select patients for subsequent FNA.

Diagnosis of Chest Wall Tuberculosis Using Fine Needle Aspiration: A Single-Center Experience.

Minimally invasive diagnosis of chest wall tuberculosis remains a challenge. Fine needle aspiration (FNA) is a simple and safe method of sampling. However, previous studies have shown that conventional tuberculosis tests had poor diagnostic performance in the needle aspirates. With the popularization of molecular detection application, the value of FNA in the diagnosis of chest wall tuberculosis needs to be reevaluated. We retrospectively studied patients with suspected chest wall tuberculosis at admission who underwent FNA for diagnosis and reported the diagnostic efficacy of acid-fast bacilli smear, mycobacterial culture, cytology and Xpert MTB/RIF (GeneXpert) when testing FNA specimens. A composite reference standard (CRS) was used as the diagnostic gold standard for this study. Among 89 included FNA specimens, acid-fast bacilli smear, mycobacterial culture, and GeneXpert were positive in 15 (16.85%), 23 (25.8%), and 61 (68.5%), respectively. Thirty-nine (43.8%) had cytologic features suggestive of tuberculosis. According to CRS, 75 (84.3%) cases were categorized as chest wall tuberculosis, 14 (15.7%) were not diagnosed with tuberculosis. Using CRS as the gold standard, acid-fast bacilli smear, mycobacterial culture, cytology and GeneXpert exhibited sensitivity of 20%, 30.7%, 52% and 81.3%, respectively. Specificity in these four tests was found to be 100%. Sensitivity of GeneXpert was significantly higher than that of smear, culture and cytology, X 2=66.3, p<0.001. GeneXpert achieved higher sensitivity as compared to cytology and conventional TB tests in the chest wall FNA specimens. Theimplementation of GeneXpert may increase the diagnostic efficacy of FNA in the diagnosis of chest wall TB.

Diagnosing pancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1 in daily practice.

BackgroundIn multiple endocrine neoplasia type 1 (MEN1), pancreatic neuroendocrine tumors (PanNETs) have a high prevalence and represent the main cause of death. This study aimed to assess the diagnostic accuracy of the currently used conventional pancreatic imaging techniques and the added value of fine needle aspirations (FNAs).MethodsPatients who had at least one imaging study were included from the population-based MEN1 database of the DutchMEN Study Group from 1990 to 2017. Magnetic resonance imaging (MRI), computed tomography (CT), endoscopic ultrasonography (EUS), FNA, and surgical resection specimens were obtained. The first MRI, CT, or EUS was considered as the index test. For a comparison of the diagnostic accuracy of MRI versus CT, patients with their index test taken between 2010 and 2017 were included. The reference standard consisted of surgical histopathology or radiological follow-up.ResultsA total of 413 patients (92.8% of the database) underwent 3,477 imaging studies. The number of imaging studies per patient increased, and a preference for MRI was observed in the last decade. Overall diagnostic accuracy was good with a positive (PPV) and negative predictive value (NPV) of 88.9% (95% confidence interval, 76.0–95.6) and 92.8% (89.4–95.1), respectively, for PanNET in the pancreatic head and 92.0% (85.3–96.0) and 85.3% (80.5–89.1), respectively, in the body/tail. For MRI, PPV and NPV for pancreatic head tumors were 100% (76.1–100) and 87.1% (76.3–93.6) and for CT, 60.0% (22.9–88.4) and 70.4% (51.3–84.3), respectively. For body/tail tumors, PPV and NPV were 91.3% (72.0–98.8) and 87.0% (75.3–93.9), respectively, for MRI and 100% (74.9–100) and 77.8% (54.3–91.5), respectively, for CT. Pathology confirmed a PanNET in 106 out of 110 (96.4%) resection specimens. FNA was performed on 34 lesions in 33 patients and was considered PanNET in 24 [all confirmed PanNET by histology (10) or follow-up (14)], normal/cyst/unrepresentative in 6 (all confirmed PanNET by follow-up), and adenocarcinoma in 4 (2 confirmed and 2 PanNET). Three patients, all older than 60 years, had a final diagnosis of pancreatic adenocarcinoma.ConclusionAs the accuracy for diagnosing MEN1-related PanNET of MRI was higher than that of CT, MRI should be the preferred (non-invasive) imaging modality for PanNET screening/surveillance. The high diagnostic accuracy of pancreatic imaging and the sporadic occurrence of pancreatic adenocarcinoma question the need for routine (EUS-guided) FNA.

Considerations for Thyroid Fine Needle Aspiration (FNA) Biopsies During the COVID-19 Pandemic

Considerations for Thyroid Fine Needle Aspiration (FNA) Biopsies During the COVID-19 Pandemic

Diagnosed values of fine needle aspiration combined with contrast-enhanced ultrasonography in the diagnosis of early thyroid microcarcinoma

Objective To analyze the role of thyroid imaging reporting and data system(TI-RADS), contrast-enhanced ultrasound(CEUS), fine needle aspiration cytology (FNAC) and tumor proliferation related genes in the early diagnosis of thyroid micro-papillary carcinoma(PTMC) and risk assessment of early metastasis. Methods From May 2018 to May 2019, a total of 140 patients with Thyroid micronodules for surgical resection and pathological diagnosis of benign or malignant into the Seventh People′s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine for the retrospective study.There were 90 cases in benign group and 50 cases in malignant group.The levels of TI-RADS, CEUS enhancement mode, peak intensity (PI) and cyclin D1 (CCND1), cell nuclear Proliferating Antigen (PCNA) and vascular endothelial growth factor (VEGF) were compared between malignant and benign groups, VEGF) mRNA expression level.The positive rate of FNAC, TNM stage, capsule invasion and lymph node metastasis were evaluated. Results The percentage of class four and more by TI-RADS grade in malignant group was significantly more than benign group((92.0% (46/50) vs.5.6% (5/90), χ2=103.718, P<0.001), more early low enhancement by CEUS(86.0%(43/50) VS.6.7%(6/90), χ2=91.328, P<0.001) and PI value higher than benign group, too((6.79±1.88) VS.(5.32±1.46), t=4.968, P=0.008). The positive rate of FNAC in malignant group was 92.0% (46/50). FNAC was positive in 42 cases of TNM stage, 9 cases of capsule invasion and 6 cases of lymph node metastasis.The pathological positive rate after resection was 50 cases of TNM stage, 10 cases of capsule invasion and 6 cases of lymph node metastasis.The expression of CCND1, PCNA and VEGF mRNA in malignant group was significantly higher than that in benign group((0.5624±0.134) VS.(0.213±0.097), t=15.639, P<0.001; (0.453±0.126) VS.(0.186±0.056), t=20.253, P<0.001; (0.633±0.159) VS.(0.252±0.097), t=31.265, P<0.001). Conclusion Ultrasound-guided FNAC is used to determine TNM staging, capsule invasion and lymph node metastasis, CCND1, PCNA and VEGF expression level, contrast-enhanced mode and peak intensity value measured by quantitative evaluation software have good accuracy for early diagnosis of PTMC, and are consistent with the pathological results of hand surgery. Key words: Thyroid micro-papillary carcinoma; Thyroid Imaging Reporting and Data System; Contrast-enhanced ultrasound; Fine needle aspiration cytology

Accuracy of fine needle aspiration compared to core needle biopsy in breast masses

Background and aims: Breast cancer is one of the main causes of death in women, the early diagnosis of which is made by physical examination, mammography, ultrasound, and biopsy of breast masses. The aim of this study was to assess the diagnostic accuracy of fine needle aspiration (FNA) compared to core needle biopsy (CNB) in breast masses. Methods: The current descriptive study was conducted in Kashani and Hajar hospitals in 2015. And a total of 200 patients diagnosed with breast masses participated in this study. First, patients referred to the clinic, received local anesthesia in the area, and then underwent FNA using 10 cc syringes and 23G needles, and simultaneously CNB specimens were taken by a special needle for diagnosis. FNA and CNB specimens were transferred to the Pathology Department with a few day interval for cytological interpretation. Results: The sensitivity and specificity of FNA compared to CNB in the diagnosis of malignant breast masses were 83.9% and 89.9%, respectively. Moreover, the positive and negative predictive values of FNA for breast masses were 78.8% and 92.5%, respectively. The accuracy of FNA test for breast masses was also 0.88%. Conclusion: According to the results of this study, FNA test had a high sensitivity, specificity, and predictive value in the diagnosis of breast masses. Therefore, it could be used as an appropriate diagnostic tool, and could obviously save many costs as well.

The diagnostic value of fine needle aspiration in comparison with frozen section in thyroid nodules: A 20-year study.

Background:Fine needle aspiration (FNA) is the most important method in the diagnosis of thyroid nodules before surgery. Recently, the efficiency of FNA in thyroid nodule management has been debatable. On the other hand, intraoperative frozen section (FS) has been used to confirm the diagnosis of FNA and select the proper surgical approach. In this regard, the present study aimed to assess the diagnostic value of FNA as compared to FS in the diagnosis of thyroid nodules.Methods: This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other.Results: This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other.Conclusion: FNA was considered as a simple, less invasive and cost effective method with fewer side effects for evaluation of thyroid nodules. Particulary it had a high sensitivity and specificity in experienced and skilled hands.

Value of Fine Needle Aspiration Combined with Ancillary Tests as a Diagnostic Modality in Hodgkin Lymphoma: A 10-Year Experience in One Academic Institution

Value of Fine Needle Aspiration Combined with Ancillary Tests as a Diagnostic Modality in Hodgkin Lymphoma: A 10-Year Experience in One Academic Institution

Diagnostic Value of Fine Needle Aspiration in Salivary Gland Tumors Compared with the Histopathological Results after Mass Excision

Diagnostic Value of Fine Needle Aspiration in Salivary Gland Tumors Compared with the Histopathological Results after Mass Excision

Submandibular gland excision.

to analyze the value of fine needle aspiration and the rates of postoperative complications in patients undergoing resection of the submandibular gland. we analyzed the records of patients treated with resection of the gland from January 1995 to December 2008. The data collected included age, gender, findings on clinical history, surgical procedure, results of fine needle aspiration (FNA), pathological diagnosis and complications. 117 patients were studied, aged 12-89 years (mean 48), 70 women and 47 men. Thirty-nine patients (33.3%) were affected by inflammatory diseases (28 patients with lithiasis), 70 had benign tumors, and malignant tumors, eight. Regarding FNA, the sensitivity and specificity were 85.7% and 100%, respectively. Nine patients (7.7%) had temporary paralysis of the marginal mandibular nerve and one had permanent paralysis. resection of the submandibular gland is a safe procedure, with low complication rates.

Diagnostic Value of Fine Needle Aspiration and Core Needle Biopsy for Initial Evaluation of Lymphoma

Diagnostic Value of Fine Needle Aspiration and Core Needle Biopsy for Initial Evaluation of Lymphoma

Value of fine-needle aspiration in diagnosis of thyroid nodules: recent progress

Thyroid nodule(TN) is a common endocrine disease.The treatments and prognoses can be very different due to the malignant and benign property of the TN.Malignant TN lacks characteristic signs or symptoms,and the accuracy of ordinary diagnostic methods is not very satisfactory.Fine-needle aspiration(FNA) can improve the accuracy by obtaining a small amount of suspected thyroid cells for cytological diagnosis.The paper is to review the achievements made in FNA and the related molecular biology for the diagnosis of TN in recent years.

Axillary lymph node status in breast cancer staging: What patient and tumor factors affect the accuracy of ultrasound-guided fine needle aspiration?

1126 Background: The purpose of the study is to evaluate the accuracy of ultrasound-guided fine needle aspiration (FNA) of axillary lymph nodes(ALNs) in patients with breast cancer and to determine factors that influence accuracy of ultrasound-guided FNA. Methods: Retrospective review of patients with breast cancer who had FNA of ALNs as well as sentinel lymph node excision or complete axillary dissection. Patients treated with neoadjuvant chemotherapy were excluded. 55 axillary FNAs in 54 patients were included in the final analysis. Pathology reports were reviewed for size of the primary tumor, FNA results, number of positive ALNs, and greatest tumor size in ALNs. FNA was performed if a suspicious lymph node was identified. Surgical sentinel lymph node biopsy or full axillary dissection were the reference standard. Micrometastases (&lt; 0.2 mm) and isolated tumor cells in the lymph node were included in the negative group. Atypical and nondiagnostic FNA results were considered negative cytologic results. Significance was analyzed using the Mann-Whitney test. Results: Size of the primary cancer ranged from 0.3 mm to 8.5 cm. The sensitivity of FNA was 73%, with positive predictive value of 97% and negative predictive value of 52%. The NPV of FNA for primary tumors &lt;1 cm, 1.1-2, 2.1-5 and &gt;5 cm is 100%, 36%, 50% and 66% respectively. Correlation of primary tumor size with sensitivity of FNA was not statistically significant. The sensitivity of FNA for lymph nodes with metastatic deposit &lt; 5mm, 6-10mm, 11-15mm, 16-20mm, and 21mm+ is 0%, 57%, 59%, 89%, and 100%, which is statistically significant (p = 0.007). The number of positive ALNs at axillary dissection is not correlated to the sensitivity of FNA. The sensitivity of FNA for 1-3, 4-9 and 10+ positive ALNs is 78%, 64% and 80%. Conclusions: Our findings indicate that FNA of suspicious axillary lymph nodes is valuable even in small tumors, which differs from the literature. The overall negative predictive value of FNA is 52%, so sentinel lymph node biopsy is essential after negative FNA. Sensitivity of FNA increases with the size of the metastatic deposit in the lymph node, but is not correlated to the number of positive ALNs found at dissection.

Fine needle aspiration and core needle biopsy in the diagnosis of lymphadenopathy of unknown aetiology

The clarification of enlarged lymph nodes is a common issue in clinical routine. By now, open surgery with complete lymph node extirpation, followed by histopathology, is considered as standard. We investigated the value of fine needle aspiration (FNA) and core needle biopsy (CNB) when supporting the conventional morphology by immunotyping. In total, 101 lymph nodes (reactive, n = 19; lymphoma, n = 46; metastatic, n = 36) were examined. CNB specimens were sufficient for unequivocal diagnosis by histopathology in 95 %. The FNA cytology allowed a correct diagnosis in 49 %. When supported by immunocytology, the success rate improved to 72 %. By accepting "suspicious of" as correct diagnosis, the ratio increased to 91 %. Additional use of flow cytometry in 46 samples minimized the "suspicious of" diagnoses and increased the proportion of unequivocal diagnoses in FNA specimens to 87 %. Flow cytometry allowed a correct subtyping in 20 of 21 B cell lymphoma but recognised only one of five Hodgkin lymphoma. All eight reactive samples were correctly diagnosed by flow cytometry. In summary, CNB allows a reliable clarification of an unclear lymphadenopathy. FNA is a powerful first diagnostic approach, especially if cytology is supported by immunocytology. The most substantial contribution of flow cytometry in FNA is the discrimination between reactive lymphadenopathy and B cell lymphoma.

Diagnostic Value of Fine-Needle Aspiration in Head and Neck Lymphoma: A Cross-Sectional Study

The objective of this paper was that fine-needle aspiration (FNA) has become a well-liked modality in the diagnosis, staging, and follow-up of head and neck masses. Limited studies exist regarding the value of FNA in the diagnosis of head and neck masses. We aimed to evaluate the diagnostic value of head and neck lymphomas. This cross-sectional study method was performed in Imam Hospital and Cancer Institute affiliated to Tehran University of Medical Sciences. In a 5years period between January 2006 and June 2010, we enrolled all patients with cervical mass (es) who had undergone FNA as the primary diagnostic modality and then underwent biopsy (excisional or open). Results of FNA were compared with histopathological study as a gold standard method. Finally, 47 patients were recruited. It was found that FNA had a sensitivity of 88% (CI 95%=79-97), a specificity of 81.2% (CI 95%=70-92), a positive predictive value of 84.6% (CI 95%=75-95), a negative predictive value of 85.7% (CI 95%=77-95) and an accuracy of 85.1% (CI 95%=75-95) in the diagnosis of head and neck lymphoma. We conclude that FNA has a considerable value in differentiation of head and neck lymphoma from non-lymphoma etiologies and is recommended as a screening test for the diagnosis of head and neck lymphoma.

Palpable lesions as a diagnostic tool in patients with thoracic pathology

Palpable lesion(s) noticed in a patient with thoracic disease may be a useful diagnostic tool and it often gives a clue for further management. In this study, we searched the diagnostic value of palpable lesions in patients with thoracic pathology suspected clinically and/or radiologically. We prospectively examined the correlations of clinical/radiologic and pathologic findings of 72 palpable lesions from 68 patients who presented with suspect for a thoracic disease from two tertiary medical centers. Thirty-two lesions (44.4%) were diagnosed as malignant either by fine-needle aspiration (FNA) only or FNA with confirmatory biopsy. The most common malignancy was non-small-cell carcinoma (10) followed by adenocarcinoma (6), and small-cell carcinoma (5). The most common localization of the palpable lesions was cervical region (20.8%) followed by left supraclavicular (13.8%) and anterior chest wall (13.8%). FNA was effective in obtaining an accurate diagnosis in 66.6% of the patients. Tissue confirmation of FNA was performed in 54 patients. The sensitivity, specificity, negative predictive value, and positive predictive value of FNA in distinguishing a malignant lesion from a benign disease for these palpable lesions were 75, 97, 96, and 80, respectively. One false negativity and one false positivity were also found. Abnormal radiologic features were not correlated with having a malignant palpable lesion. Evaluation of the palpable lesions by FNA and tissue biopsy together is effective for initial triage of the patients with suspect for a thoracic pathology. FNA alone is a convenient and easy method for this purpose especially when the material is immediately assessed for specimen adequacy.

Fine‐needle aspiration cytology and flow cytometric immunophenotyping in diagnosis and classification of non‐Hodgkin lymphoma in comparison to histopathology

This prospective study aimed to compare the value of fine needle aspiration (FNA) cytology (FNAC) and flow cytometric immunophenotyping (FCI) with histopatopathology (HP) in the diagnosis and classification of non-Hodgkin lymphoma (NHL). Twenty-nine excised lymph nodes suspected of NHL were evaluated using FNAC, FCI, and HP. Specimens were divided into two equal parts; one for HP and the other for FNAC and FCI. Results were compared in terms of diagnosis (malignant, benign or reactive, and metastatic) and NHL class. With combined FNAC/FCI, 11 (37.9%) cases were diagnosed as NHL, 11 cases (37.9%) as reactive lymph node, six cases (20.6%) as Hodgkin's lymphoma, and one case (3.4%) as metastasis. HP revealed nine cases (31%) of NHL, five cases (17.2%) of reactive lymph nodes and all the diagnosed metastatic and Hodgkin's lymphoma. Considering histology as a gold standard method in diagnosis, the sensitivity, specificity, PPV and NPV of FNAC/FCI in differentiate malignant and benign lesion were 73.9%, 83.3%, 94.4%, and 45.5%, respectively and in differentiate NHL from others were 75%, 93.8%, 90%, and 83.3%, respectively. Cytology and HP in addition to FCI and HP are significantly different from determination of NHL lesions point of view (P = 0.001 and P < 0.0001, respectively). However, FCI can be considered as an adjunctive method for Cytology especially because Cytology is not competent enough to differentiate between benign lesions and Lymphoma. Additionally, FCI is shown to be an accurate method in classifying NHL.

Characteristics and prognosis of primary thyroid non‐Hodgkin's lymphoma in Chinese patients

There exists no universally accepted treatment for primary thyroid non-Hodgkin's lymphoma (TNHL) due to the rarity of this entity. The aim of this study is to assess the role of surgery and to explore prognostic factors in Chinese TNHL patients. Patient presentations, pathologies, surgical interventions, multidisciplinary treatment, prognostic factors and the value of fine needle aspiration were analyzed. Between 1991 and 2007, 40 patients of TNHL were diagnosed. Thirty-eight patients underwent an initial surgical procedure. Further treatments consisted of radiotherapy or chemotherapy alone, and the majority of patients were treated with combined chemo-radiation. After a median follow-up of 95 months, the 5-year overall survival (OS) and relapse-free survival (RFS) was 82% and 74%, respectively. Survival curves showed no significant difference between therapeutic operations when compared with diagnostic operations. A univariate analysis showed both International Prognostic Index (IPI) and staging significantly influenced OS and RFS. In multivariate analysis, IPI was found to be the only prognostic factor. Combined chemotherapy and radiotherapy may offer better outcome without the need for extensive resection, and surgery should be reserved to providing tissue for diagnosis. The patients with low-intermediate risk (IPI = 2) or stage IIE need be treated more aggressively.

The need to reassess the value of fine needle aspiration in the diagnosis of tuberculous cervical lymphadenitis in Iran

Iran is an endemic country for tuberculosis (TB). After the eradication and efficient control of some priority infectious diseases such as polio and measles TB has now turned into a major public health problem in Iran. Cervical lymphadenitis is the most common form of extrapulmonary TB accounting for 30-40% of TB cases and fine needle aspiration (FNA) is widely accepted as the first diagnostic modality of choice in this entity especially in countries where mycobacterial infection is endemic. FNA is easy safe rapid and noninvasive compared to excisional biopsy which is usually considered the second choice. It is readily available in most centres and can safely be performed in outpatient departments. The diagnostic accuracy of FNA for tuberculous cervical lymphadenitis varies considerably among different studies with a reported sensitivity of 25-100%. This variation might be due to differences in geographical location and endemicity expertise of the clinician and pathologist and the time lapsed before the lymphadenopathy comes to the patients attention. Recently we became aware of several small informal reports from different regions in our country warning about high false negative rates of FNA results and that seemed especially worrying in cases of patients who referred early in the course of their disease. Therefore we opted to assess the issue of FNA sensitivity for (early) tuberculous cervical lymphadenitis in Iran for the first time. (excerpt)

Clinical value of image-guided fine needle aspiration of retroperitoneal masses and lymph nodes in gynecologic oncology

Objective. Evaluation of the sensitivity and specificity of fine needle aspiration of retroperitoneal masses and lymph nodes in gynecologic oncology. Methods. Retrospective study of 101 punctures administered to 84 patients aged 23–86 years. The method's sensitivity and specificity were evaluated by clinical follow-up. Results. A satisfactory sampling was obtained in 89.1% of punctures, and a cytological diagnosis was made in 88.1%. The size of the lymph nodes punctured was less than 14 mm in 46.5%. This test has a sensitivity of 87.5%, specificity of 88.9%, positive predictive value of 98%, negative predictive value of 53.3%, and accuracy of 87.7%. Four patients presented complications: pain (2), hematoma (1), and right ureteral perforation (1). Conclusions. The fine needle aspiration technique has excellent positive predictive value and low morbidity. As a method of visualization, CT-scan, in combination with lymphography, allows the location of small lesions and the definition of their internal structures. The weak negative predictive value of fine needle aspiration might be correctible by laparoscopy-directed biopsy, and its potential is clearly ensured by the development of techniques for locating sentinel lymph nodes.