Evaluation of Intra Thorasic Lesions by Image Guided Fine Needle Aspiration Cytology

Abstract

Introduction: For diagnosing  variousthorasic lesions ultrasound guided FNAC is a safe, radiation free, technically simple and cost effective method. CT guided FNAC is another commonly used method where lesion is difficult to access through ultrasound, but it is not radiation free and comparitively expensive also. Study aimed and evaluated the role of ultrasound guided percutaneous fine needle aspiration cytology in diagnosing various thorasic lesions. Material and Methods: An institutional based study was conducted in 24months duration involving lungs, pleura and mediastinum. A total 100 patients referred to ultrasound guided FNAC with suspected mass lesions. A detailed medical and surgical history, clinical examination was done. Routine investigations (CBC, BT, CT, PT and APTT) were done before the procedure. Written consent was taken from each patient. FNAC was done and five to seven smears were prepared, fixed and stained with H&E stain. Result: Out  of 100 patients diagnostic material was obtained in 86  cases  which  were included out of  86 cases 80 cases (93.02%) from lung, 4 cases (4.65%) from pleural mass and  2 cases(2.32%) from mediastinum.The age of patients vary from 25 to 80 years. Most of the patients were in the age group of 50 to 70 years. The most common tumor was squamous cell carcinoma diagnosed i in 69 cases (80.23%), adenocarcinoma in 13 (15.11%) patients, small cell carcinoma in 2(1.32%) patients, poorly differentiated carcinoma in one (1.16%) patient and thymoma in one (1.16%) patient. 52 ( 60.46%) patients had history of smoking. Conclusion: Ultrasound guided FNAC is a simple, safe and highly sensitive and specific procedure with high diagnostic  accuracy for diagnostic thorasiclesions. Diagnostic accuracy of cytology with FNAC was around 96.6%.

Keywords: fine needle aspiration cytology, lung tumors ,pleurallesions, mediastinalmass and diagnostic accuracy