Usefulness of Image Guided Fine Needle Aspiration Cytology in the Assessment of Intra-abdominal Lesions

Abstract

Introduction: The appropriate diagnosis of intra-abdominal lesions is difficult and often requires histopathological confirmation. Image guided Fine Needle Aspiration Cytology (FNAC) is a simple, readily available, safe, inexpensive, time saving, rapid procedure which prevent unnecessary surgical interventions. Aim: The study was conducted to determine the diagnostic efficacy of image guided FNAC in the assessment of intra- abdominal lesions and to determine age and sex distribution. Materials and Methods: This cross-sectional study was conducted in Department of Pathology SN Medical College Agra (from September 2019 to September 2021. Two hundred and seven patients who were detected to have abdominal lesions by Ultrasonography (USG) or Computed Tomography (CT), image guided Fine Needle Aspiration (FNA) was performed under all aseptic condition. The sample was spread onto slides, air-dried and stained with Giemsa and was fixed in 95% ethanol and stained with Papanicolaou’s stain. The cyto-histopathological association was done wherever possible, the overall accuracy, sensitivity, specificity, the Negative Predictive Value (NPV) and Positive Predictive Value (PPV) was calculated. Results: Out of 207 patients, 110 were males and 97 were females with male to female ratio of 1.13:1. Out of 207 cases, the aspirate was satisfactory in 201 (97%) cases. Unsatisfactory aspirate was obtained in 06 (3.0%) of cases. Among 207 cases, most common lesions were malignant 170(82.1%) cases, followed by inflammatory 31 (14.9%) cases and unsatisfactory 06 (3.0%) cases. Most common age group for malignant lesions was 59-68 years with 45 (26.4%) cases followed by 49-58 years with 41 (24.1%) cases. The majority of aspirates were from liver 78 cases (38.2%), followed by 47 cases (22.71%) from gall bladder and 44 cases (21.30%) from the lymph nodes. The sensitivity was 92.3% while specificity was 100%. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 100% and 91.4%, respectively. The diagnostic accuracy of image guided FNAC was 95.8%. Conclusion: FNA of abdominal lesions guided by ultrasound is a quick, low-cost, safe, highly accurate, and minimally invasive approach for getting a tissue diagnosis in solid localised lesions of the abdomen.

Keywords

• benign
• computed tomography
• liver
• malignant
• ultrasonography