Publication:

Importance of image guided fine needle aspiration in diagnosis of benign and malignant lesions

Background Intrathoracic, intraabdominal and retroperitoneal tumors especially at inaccessible site pose difficulty in diagnosis. The present study was done to assess the utility of image guided FNAC in the diagnosis of intrathoracic, intra-abdominal and retroperitoneal lesions.

Methods This retrospective study was done in Department of Pathology in collaboration with Department of Radiology for a period of three and half (31/2) years. A total of 5608 aspirations were performed. One hundred and seventy five (175) procedures were done under image-guidance. Air dried and wet fixed smears were stained with May Grunwald Giemsa (MGG) and Papanicolaou stain respectively and Acid Fast Bacilli (AFB) stain in case of suspected tubercular lesion.

Results The number of intra-abdominal lesions were 104 (59.5%), intrathoracic lesions 32(18.2%), retroperitoneal lesions 21(12%) while lesions under miscellaneous category were 18(10.3%). Out of 109 malignant tumors, majority were intra-abdominal 72 cases (66.1%), with liver as the main contributor (35 cases), followed by intrathoracic 20 cases (18.3%), retroperitoneal 12cases (11%) and finally miscellaneous category constituted 5 cases (5.5%). Metastatic adenocarcinoma was the most common tumour (19 cases) in liver followed by 14 cases of adenocarcinoma each in GIT and gall bladder. Non-small cell carcinoma (9 cases) was common malignancy diagnosed in inrathoracic region while neuroblastoma (4 cases), Wilm’s tumour (3 cases) and renal cell carcinoma (2 cases) were the commonly observed tumors among retroperitoneal lesions.

Conclusions Percutaneous FNAC under image guidance surpass the diagnostic difficulties and facilitates the rapid management of the patient.