A Study of Ultrasound-Guided Fine Needle Aspiration Cytology in Various Intraabdominal and Pelvic Lumps With Histopathological Correlation

Abstract

BACKGROUNDIn surgical practice evaluation of deep, abdomino-pelvic masses or focal lesions involving abdominal sites is often difficult and challenging. Distinction between malignant and non-malignant lesions and particularly inflammatory lesions is vital for patient management. It is mandatory to make a documentary evidence of the nature of the lesion before the institution of therapy and for the prognosis. Nowadays, FNAC is a very good alternative for surgical procedures like diagnostic laparotomy. Aims and Objectives-To study the cytomorphological features, age and sex distribution of intra-abdominal lesions; to categorise them as inflammatory, benign and malignant lesions with histopathological correlation; and to evaluate the sensitivity, specificity and diagnostic accuracy. MATERIALS AND METHODSIt is a descriptive type of study that included 94 patients with clinically or sonologically diagnosed abdomino-pelvic masses. FNAC was performed under US guidance. The aspirates were smeared into a minimum of 2 slides and they were routinely stained with H and E, MGG stain. RESULTSIn this study, 94 cases of intra-abdominal lumps were subjected to USG guided FNAC. Out of 94 cases there were 68 (72.4%) malignant, 10 (10.6%) benign, 11 (11.7%) inflammatory and 05 (5.3%) unsatisfactory smears. In our study, liver and the gall bladder were the most common sites. Adenocarcinomas and hepatocellular carcinomas were the most common malignant lesions. This study showed 91.4% sensitivity, 100% specificity, 100% positive predictive value, 83.3% negative predictive value and diagnostic accuracy of 94%. CONCLUSIONIntra-abdominal FNAC is widely accepted as a simple, economical and a safe OPD procedure in the presence of expert cytopathologist with high sensitivity, specificity and diagnostic accuracy, and it can be used as important diagnostic tool for a preoperative diagnosis and management of intra-abdominal lesions. Most of the intra-abdominal masses are non-palpable and even if they are palpable the idea of their size and shape and the extent of the lesion is not possible. Use of imaging modalities like fluoroscopy, CT and USG helps in localisation of lesions and also improved adequacy of sample. 1 'Financial or Other Competing Interest': None. Submission 10-09-2017, Peer Review 20-01-2018, Acceptance 27-01-2018, Published 05-02-2018. Corresponding Author: Neetu Purwar, #35/New Type 4, GSVM Medical College, Kanpur-208002, U. P. E-mail: neetu.purwar@gmail.com DOI: 10.14260/jemds/2018 Ultrasound guided FNAC is a common and widely accepted as a safe diagnostic procedure in which any structure visualised can be reached quickly and precisely by a fine needle and it is substitute for surgical procedures like diagnostic laparotomy. 2 FNAC is a highly sensitive, highly specific, accurate and a cost effective diagnostic procedure as shown in most studies with a negligible complication rate. 3,4,5,6 However, an absolute contraindication is uncorrectable severe coagulopathy. 7 Liver is an abdominal organ for which perc...