Background and Objectives. Thoracic lesions account for various benign and malignant conditions. Of these lung carcinoma (mainly primary) is the most common carcinoma in the world. The present study was undertaken to know the pathological spectrum of thoracic lesions and to correlate cytoradiological findings. Materials and Methods. The present study was conducted in a tertiary care center of North India on 74 patients over an 18-month period. CT guided transthoracic FNAC (TTFNA) was carried out, and aspirates were drawn, examined, and compared with radiological diagnoses. Results. The diagnostic accuracy for FNA in the present study was calculated to be 95.94% (using cytology as the gold standard). The predominant lesion was malignancy (85.1%), followed by suspicions of malignancy and inflammatory pathology (5.40% each). By cytology, the most common malignant lesion was adenocarcinoma (48%) followed by squamous cell carcinoma (40%), small cell carcinoma (8%), and undifferentiated carcinoma (4%). Cytoradiological correlation was found to be 89.2% in the present study. Conclusion. Present study thus concludes that TT FNA of thoracic lesions is a simple, safe, economically prudent technique associated with low morbidity and leading to quick and early diagnosis.

/pdf/cytologic-radiologic-correlation-using-transthoracic-ct-37so4oq133.pdf

Cytologic-radiologic correlation using transthoracic CT-guided FNA for lung and mediastinal masses: our experience.

Ultrasound guided needle pleural biopsy in patients with undiagnosed pleural effusion

CT guided FNAC is a well established method in the cytological diagnosis of pulmonary lesion. Aim: Aim of our study is to evaluate the pathological spectrum of disease in lump through CT guided FNAC. Material & method: 69 causes were evaluated retrospectively for a period of 4 yrs. Result: out of 69 cases 52.1% were male. Mean age was 54. 34 years. 65.2% having malignant lesion & 34.7% have benign. Adeno CA was the predominant malignant tumour. Conclusion: CT guided FNAC can diagnose pulmonary lesion fairly accurately leading to less morbidity & mortality as treatment can be started early.

/pdf/ct-guided-fnac-of-lung-mass-a-retrospective-study-of-disease-4h8m0yjoor.pdf

CT Guided FNAC of lung mass – A retrospective study of Disease Spectrum

Transforaminal Endoscopic Approach for Large-Sample Tumor Biopsy using Beveled Working Channel for Core Technique: A Technical Note.

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.

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

Background: Transthoracic fine needle aspiration cytology (FNAC) is an established and safe technique for diagnosis of thoracic mass lesions. Computed tomography (CT) scan depicts clear anatomical details and provides access to any area of the body. It is, however, expensive and the needle is not passed in real time. Ultrasound is cheaper, radiation free, and allows real time monitoring. Its limitations are obscurement of lesions by aerated lung, smaller, deep seated, and cavitary lesions. Aims: This study aims to compare sensitivity and specificity of CT scan and ultrasonography (USG) in thoracic FNAC. Materials and Methods: The study was conducted on patients who presented with thoracic mass lesions in lungs, mediastinum, hilar lymph nodes, thoracic vertebrae, paraspinal soft tissue, and pleura. One hundred and twenty patients were studied. Only those cases in which sonographic guidance was not possible were taken up for CT guided FNAC. The lesions were assigned to benign and malignant categories and into specific diagnoses where possible. Biopsy correlation was available in 113 cases. Patients were lost to follow-up in five lung and two mediastinal masses. Statistical Analysis: Statistical tests applied included diagnostic tests for sensitivity and specificity. Results: An accuracy of 70.8% was found for image guided FNACs with a sensitivity and specificity of 92.2% and 100%, respectively. CT had a sensitivity of 93.2% and specificity of 100%. For USG guidance, the same was 91.3% and 100%, respectively. Conclusions: Precision of USG and CT scan is comparable for guidance in FNAC from thoracic mass lesions.

Evaluation of precision of guidance techniques in image guided fine needle aspiration cytology of thoracic mass lesions.

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Evaluation of precision of guidance techniques in image guided fine needle aspiration cytology of thoracic mass lesions.