Diagnostic Efficacy of Ultrasound and CT-Guided Percutaneous Fine Needle Aspiration Cytology for Intrathoracic Masses

Abstract

Introduction

Image-guided percutaneous fine needle aspiration cytology (FNAC) performed under ultrasonographic and Computed tomography (CT) guidance is a fast, acceptable and accurate diagnostic investigation for diagnosing intrathoracic masses. It helps in confirming suspected malignancy and in characterizing inflammatory, benign and malignant lesions. The choice between the use of ultrasonography or CT as a guidance method depends largely upon the size, visibility and location of the lesion to be sampled, the patient’s body type and the cost of guidance methods.

Material and methods

The study consisted of 30 cases of ultrasonographic and CT-guided
FNAC of intrathoracic masses over a period of two years.

Results

Out of the total 30 cases of intrathoracic lesions, a specific cyto-diagnosis was made in 26 lesions thereby giving a diagnostic yield of 86.7%. In 4 cases, no definite cyto-diagnosis could be made as either the material was unsatisfactory or non- representative of the lesion. Histopathological correlation could be done in 7 cases. Out of the 7 cases, cytology diagnosis was concordant with histopathological examination in 6 cases, thereby giving an overall sensitivity and specificity of the ultrasound and CT-guided FNAC in diagnosing intrathoracic masses as 85.7% and 100% respectively.

Conclusion

The present study thus demonstrates that percutaneous FNAC under Ultrasound or CT guidance is a quick, reliable and convenient method and should be considered as a primary investigative method for diagnosis of intrathoracic masses as it is cost-effective, safe and well tolerated by the patients. It also allows an early diagnosis which provides an opportunity for the expeditious treatment of patients.