Assessment of Demographic Profile and Cytopathological Diagnosis of Thoracic Mass Lesions Using CT-guided FNAC
Keywords:
Adenocarcinoma, Computed tomography, Fine needle aspiration cytology, Squamous cell carcinoma
Abstract
Background and Aim: Computed tomography (CT) guided Fine needle aspiration cytology (FNAC) is a simple, safer, and rapid technique. CT guidance can assist FNAC from any part of thorax without any major complications. FNAC helps distinguish between benign and malignant lesions and also effectively aids in morphological typing of lung cancer, thereby reducing the delay in initiation of specific therapy like chemotherapy or surgery. Materials and Method: Present study was carried out at a department of pathology GMERS Medical College, Gotri, Vadodara, Gujarat. One hundred and twenty three cases of lung mass lesions were evaluated with CT guided FNAC. Smears were stained with May-Grunwald Giemsa and Hemotoxylin & Eosin (H & E) stain for rapid cytopathological evaluation of the lesions. Results: Out of 123 cases included in the study, 90 cases (73.17%) were male and 33 (26.83%) were female. The mean age in malignant cases was 60.3 years whereas it was 50 years in benign lesions. Cytological examination showed that 109 cases were malignant and 14 cases were benign lesions. Cytomorphological diagnosis revealed maximum number of cases belonged to adenocarcinoma (60.9%). Rest of the cases were Squamous cell carcinoma (16.2%), Non-specific inflammation (4.8%), Granulomatous inflammation (3.2%), metastatic deposits (3.2%) and spindle cell neoplasm (1%). Only ten cases could be followed up for histopathological evaluation. All the cases confirmed the primary diagnosis of malignancy on histopathological examination. Conclusion: CT guided FNAC is a simple, and reliable for the diagnosis and sub typing of lung cancer, thereby reducing the delay in initiation of specific therapy like chemotherapy or surgery.References
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15. Tan KB, Thamboo TP, Wang SC, Nilsson B, Rajwanshi A, Salto-Tellez M. Audit of transthoracic fine needle aspiration of the lung: Cytological sub classification of bronchogenic carcinomas and diagnosis of tuberculosis. Singapore Med J 2002;43:570-5.
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19. Abrari A, Aziz M, Haq R. Cytology of lung tumors – study of 60 cases with emphasis on accuracy and problem areas. J Cytol. 2003;20:79–81.
2. Mondal SK, Nag D, Das R, Mandal PK, Biswas PK, Osta M. Computed tomogram guided fine-needle aspiration cytology of lung mass with histological correlation: A study in Eastern India. South Asian Journal of Cancer.2013;2(1):14-18.
3. Konjengbam R, Singh NB, Gatphoh SG. Computed tomography guided percutaneous transthoracic fine needle aspiration cytology of pulmonary mass lesions: Two years cross sectional study of 61 cases. J Med Soc. 2014;28:112-60
4. Yadav RK, Sen R, Agarwal S, Aggarwal S. CT-guided FNAC of intrarthoracic mass lesions - a study among 35 patients. J Indian Med Assoc.2010;108:571-4.
5. Jaya Shankar E, Pavani B, Chandra E, Reddy R, Srinivas M, et al. (2010) Computed Tomography Guided Percutaneous Thoracic: Fine Needle Aspiration Cytology in Lung and Mediastinum. J Cytol Histol 1:107. doi:10.4172/2157-7099.1000107.
6. Syed A, Shabab M, Uddin A. Computed tomography guided fine needle aspiration cytology of lung lesions: A study of 162 cases. J Chittagong Med Coll Teach Assoc. 2009;20:50-2.
7. Bandyopadhyay A, Laha R, Das TK, Sen S, Mangal S, Mitra PK. CT guided fine needle aspiration cytology of thoracic mass lesions: A prospective study of immediate cytological evaluation. Indian J Pathol Microbiol. 2007;50:51-5.
8. Shaheen MZ, Sardar K, Murtaza HG, Safdar SS, Hafeez A, Mushtaq MA, et al. CT guided trans-thoracic fine needle aspiration/biopsy of mediastinal and hilar mass lesions. Indian J Pathol Microbiol. 2010;16:4-13.
9. Madan M, Bannur H. Evaluation of fine needle aspiration cytology in the diagnosis of lung lesions. Turk J Pathol. 2010;26:1-6.
10. Singh J P, Garg L, Setia V. Computed tomography (Ct) guided transthoracic needle aspiration cytology in difficult thoracic mass lesions-not approachable by USG. Indian J Radiol Imaging. 2004;14:395-400.
11. Parajuli S, Tuladhar A, Basnet RB. Ultrasound and computed tomography guided fine needle aspiration cytology in diagnosing intra-abdominal and intra-thoracic lesions. J Pathol Nepal 2011;1:17-21.
12. Prashant, Ramachandra C, Pattbhiraman, Raghuram, Satya V, Attili S. Feasibility, safety, and efficacy of the CT guided fine needle aspiration cytology of lung lesions. Indian J Med Paediatr Oncol 2007;28:16-25.
13. Powers CN, Silverman JF, Geisenger KR, Frable WJ. Fine needle aspiration biopsy of the mediastinum a multi institutional analysis. Am J Clin Pathol. 1996;105:168-73.
14. Shah S, Shukla K, Patel P. Role of needle aspiration cytology in diagnosis of lung tumors. A study of 100 cases. Indian J Pathol Microbiol. 2007;50:56-8.
15. Tan KB, Thamboo TP, Wang SC, Nilsson B, Rajwanshi A, Salto-Tellez M. Audit of transthoracic fine needle aspiration of the lung: Cytological sub classification of bronchogenic carcinomas and diagnosis of tuberculosis. Singapore Med J 2002;43:570-5.
16. Salazar AM, Westcott JL. The role of transthoracic needle biopsy for the diagnosis and staging of lung cancer. Clin Chest Med.1993;14:99–110.
17. Gouliamos AD, Giannopoulos DH, Panagi GM, Fletoridis NK, Deligeorgi-Politi HA, Vlahos LJ. Computed tomography-guided fine needle aspiration of peripheral lung opacities: An initial diagnostic procedure? Acta Cytol 2000;44:344-8.
18. Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger K, Yatabe Y, et al. International association for the study of lung cancer/American thoracic society/European respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011 Feb;6(2):244-85.
19. Abrari A, Aziz M, Haq R. Cytology of lung tumors – study of 60 cases with emphasis on accuracy and problem areas. J Cytol. 2003;20:79–81.
Published
2018-08-23
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