Utility of Image Guided Fine needle aspiration in the Diagnosis Of Ovarian Masses: A Cytohistopathological Correlation
Keywords:
Image Guided FNAC, Ovary, Neoplasms
Abstract
Background: The incidence of ovarian masses has increased over the past two decades and is one of the leading causes of cancer-related deaths globally. Although histopathology remains the gold standard, in recent times, image-guided aspiration is being increasingly used as a rapid, inexpensive and efficient method for the pre-operative diagnosis of ovarian masses. The present study was performed to evaluate the efficacy of image guided FNAC in diagnosis of ovarian masses in comparison with histopathology and to assess the limitations of cytological interpretation.Methods: The study was conducted on 92 cases of ovarian masses which were evaluated by image guided FNAC. Sensitivity, specificity and diagnostic accuracy were calculated using histopathology as gold standard.Results: Cytological diagnosis was obtained in all the 92 patients with ovarian masses followed by histopathological examination. The cytological diagnosis was grouped into 2 categories- Benign/Possibly Benign (60 cases) and Malignant/Suspicious of malignancy (32 cases). On cytohistological correlation it was found that a correct diagnosis was made in 86 cases, resulting in a diagnostic accuracy of 93.4%, sensitivity of 84.3 % and specificity of 98.3%.Conclusion: Image guided FNAC seems to be a relatively safe, simple, fast and cost-effective procedure where most ovarian malignancies can be correctly diagnosed with a high accuracy.References
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10. Cole L, Mount S, Nuzzo E, Wong C. Aspiration cytology of ovarian cystic masses: histologic correlation and review of the literature. Acta Cytol 2011;55:19–25.
11. Ganjei P, Dickinson B, Harrison TA, Nassiri M, Lu Y. Aspiration cytology of neoplastic and non-neoplasic ovarian cysts: Is it accurate? Int J Pathol1996;15:94–101.
12. Roy M, Bhattacharya A, Roy A, et al. Fine needle aspiration cytology of ovarian neoplasms. J Cytol 2003;20:31–5.
13. Khan N, Afroz N, Aqil B, Khan T, Ahmad I. Neoplastic and nonneoplastic ovarian masses: Diagnosis on cytology J Cytol 2009;26(4):129–33.
14. Moran O, Menczer J, Gijlad BB, Lipitz S, Goor E. Cytologic examination of ovarian cyst fluid for the distinction between benign and malignant tumors. Obstet Gynecol 1993;82:444–6.
15. Nadji M, Greening SE, Sevin BU. Fine needle aspiration cytology in gynaecologic oncology II, morphologic aspects. Acta Cytol 1979;23:380-8.
16. Kjellgren O, Angstrom T, Bergman F. Fine needle aspiration biopsy in diagnosis and classification of ovarian carcinoma. Cancer1971;28:967-76.
17. Banik T, Gupta N, Rajwanshi A, Dhaliwal LK. Fine Needle Aspiration Cytology in Sclerosing Stromal Tumour of Ovary. A series of 3 cases. Diagnostic Cytopathology 2012:40(4); 342-5.
18. Joja I, Okuno K, Tsunode M et al. Sclerosing Stromal Tumour of Ovary. US, MR and Dynamic MR Findings. J Comput Assist Tomo 2001: 25(2);201-6.
2. Uguz A, Ersoz C, Bolat F, Gokdemir A, Vardar MA. Fine needle aspiration cytology of ovarian lesions. Acta Cytol 2005;49:144–8.
3. Hajdu S, Melamed MR. Limitations of aspiration cytology in the diagnosis of primary neoplasms. Acta cytol 1984;28:337-45.
4. Ray S, Gangopadhyay M, Bandyopadhyay A, Majumdar K, Chaudhury N. USG guided FNAC of ovarian mass lesions: A cyto-histopathological correlation, with emphasis on its role in pre-operative management guidelines. J Turk Ger Gynecol Assoc 2014; 15(1):6–12.
5. Wojcik EM, Selvaggi SM. Fine needle aspiration cytology of cystic ovarian lesions. Diagn Cytopathol1994;11:9-14.
6. Geier GR, Strecker JR. Aspiration Cytology and E2 content in ovarian tumors. Acta Cytol 1981;25:400-6.
7. Kreuzer GF, Paradowski T, Wurche KD, Flenker H. Neoplastic or Nonneoplastic ovarian cyst? The role of cytology. Acta Cytol 1995;39:882–6.
8. Mehdi G, Maheshwari V, Afzal S, Ansari HA, Ansari M. Image guided fine needle aspiration cytology of ovarian tumors: An assessment of diagnostic efficacy. J Cytol 2010;27(3):91-5.
9. Gupta N, Rajwanshi A, Dhaliwal LK, Khandelwal N, Dey P, Srinivasan R, Nijhawan R. Fine needle aspiration cytology in ovarian lesions: an institutional experience of 584 cases. Cytopathology 2012;23:300–7.
10. Cole L, Mount S, Nuzzo E, Wong C. Aspiration cytology of ovarian cystic masses: histologic correlation and review of the literature. Acta Cytol 2011;55:19–25.
11. Ganjei P, Dickinson B, Harrison TA, Nassiri M, Lu Y. Aspiration cytology of neoplastic and non-neoplasic ovarian cysts: Is it accurate? Int J Pathol1996;15:94–101.
12. Roy M, Bhattacharya A, Roy A, et al. Fine needle aspiration cytology of ovarian neoplasms. J Cytol 2003;20:31–5.
13. Khan N, Afroz N, Aqil B, Khan T, Ahmad I. Neoplastic and nonneoplastic ovarian masses: Diagnosis on cytology J Cytol 2009;26(4):129–33.
14. Moran O, Menczer J, Gijlad BB, Lipitz S, Goor E. Cytologic examination of ovarian cyst fluid for the distinction between benign and malignant tumors. Obstet Gynecol 1993;82:444–6.
15. Nadji M, Greening SE, Sevin BU. Fine needle aspiration cytology in gynaecologic oncology II, morphologic aspects. Acta Cytol 1979;23:380-8.
16. Kjellgren O, Angstrom T, Bergman F. Fine needle aspiration biopsy in diagnosis and classification of ovarian carcinoma. Cancer1971;28:967-76.
17. Banik T, Gupta N, Rajwanshi A, Dhaliwal LK. Fine Needle Aspiration Cytology in Sclerosing Stromal Tumour of Ovary. A series of 3 cases. Diagnostic Cytopathology 2012:40(4); 342-5.
18. Joja I, Okuno K, Tsunode M et al. Sclerosing Stromal Tumour of Ovary. US, MR and Dynamic MR Findings. J Comput Assist Tomo 2001: 25(2);201-6.
Published
2016-12-12
Section
Original Article
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