A prospective study on computed tomography guided fine needle aspiration cytology of peripheral lung lesions

Abstract

Introduction: Percutaneous fine needle aspiration cytology (FnAC) of the lung is generally indicated for the diagnosis of pulmonary lesions. There are many hazards associated with performing thoracotomy for lung lesions. FnAC has become a diagnostic tool to assess the nature of radiographically demonstrable lung lesions. The general acceptance of FnA has been low but the appreciation of this method for lung lesions has been rapid due to the difficulty in otherwise diagnosing small peripheral lung lesions. Fear of neoplastic implantation in the needle track may have initially inhibited its use but have proven groundless. Materials and Methods: A total of 80 cases were included in the study. The study period was from January 2020 to December 2020. All patients presented with respiratory symptoms with a localized lung lesion clinically, which was confirmed radiologically. Patients were placed in the supine, prone, right lateral or left lateral position depending on the location of the lesion so that the lesion was nearest to the aspirator. Results: The diagnostic accuracy was 95% considering cytological criteria as the standard. The most common age group affected was 41–70 years (67.5%). However age groups in both extremes of life were affected less. The youngest patient was 20 years old whereas the oldest was 78 years old. Of the forty patients, twenty-seven were males and thirteen were females. A male preponderance was therefore noted in this study with a M:F ratio of 2.081. Table I shows the distribution of the cases. The predominant lesion found in this study was malignancy in twenty-four cases (60%), followed by an inflammatory lesion in twelve cases (30%). One case each was reported as suspicious of malignancy (2.5%) and as a granulomatous lesion (2.5%). Conclusion: Percutaneous, transthoracic FnAC is a relatively simple procedure with good patient acceptance and low morbidity. It is an accurate, safe and repeatable procedure in the diagnosis of difficult lung lesions. Ct scan has enabled the visualization of previously inaccessible tumors, which can now be guided by this procedure, leading to a greater yield of cytological material and a significantly greater predictability of true positive cases in malignant lesions. FnAC should be used earlier and more frequently to shorten the diagnostic interval and allow more prompt therapy for persistent lung lesions.