Correlation of CT Findings of Thoracic Mass Lesions with CT Guided Aspiration Cytology

Abstract

Introduction: Thoracic masses have always remained an enigma in clinical practice. Computed Tomography (CT) is a useful investigation in further characterisation of suspicious thoracic masses and guided Fine Needle Aspiration Cytology (FNAC) is regarded as a quick diagnostic tool to differentiate malignant from benign thoracic mass lesions. Aim: To evaluate the CT findings of thoracic mass lesions and assess the role of CT-guided FNAC, to comparatively analyse the radiological and cytopathological results. Materials and Methods: Sixty patients with strong clinical suspicion and chest radiographic diagnosis of thoracic mass were included in the study. Their characteristic imaging findings were studied and the radiologically benign or malignant Features were correlated with cytological diagnosis. Results: Out of all the sixty cases of thoracic masses, 40 (66.67%) were localized to the lung followed by mediastinal mass in 14 cases (23.33%). Pleural effusion (malignant vs benign-57.1% vs 14.3%), collapse of adjacent lung (51.4% vs. 11.4%), mediastinal lymphadenopathy (28.6% vs. 5.7%) and chest wall invasion (25.7% vs. 0%) are more commonly seen in malignant than in benign lesions. The radiological and pathological correlation of thoracic mass in the present study was 88% which is statistically significant (p = 0.01) with a specificity of 85.7% and sensitivity of 90%. Conclusion: CT-guided FNAC of thoracic mass lesions is a safe and a rapid diagnostic procedure with less complication. Specific diagnosis can also be derived from cytomorphology alone.

Keywords

• Cytomorphology
• Radiological-pathological correlation
• Transthoracic FNAC