CT-Guided FNAC of Lung Lesions and Cytological Sub-Classification of Bronchogenic Carcinoma of 246 cases at a Tertiary Care Hospital

Abstract

Background: CT-guided fine needle aspiration cytology (FNAC) is a useful tool for evaluating lung nodules or masses. In view of the relative paucity of published studies regionally, this study was undertaken in the Department of Pathology, Enam Medical College & Hospital to see the use of the technique. Materials and Methods: Two forty six CT guided lung FNACs were performed during January 2017 to December 2018 and cytological diagnoses were made. Reported results and relevant data were recorded in the data sheet and then analyzed by standard statistical method. Results: Total number of cases were 246. Adequate samples were obtained in 228 (92.68%) cases, among the adequate samples 135 (59.41%) were malignant, and 93 (40.49%) were benign or nonmalignant lesions. Among the benign lesions, lung abscess (36;38.70%) was the most common followed by pulmonary TB (27;29.03%). Adenocarcinoma (54;40%) was the most common type of bronchogenic carcinoma followed by squamous cell carcinoma (51;37.78%), small cell carcinoma (21;15.56%), NHL (6;4.44%) and large cell undifferentiated carcinoma (3;2.22%). In male persons, squamous cell carcinoma (42.85%) was the most common type of bronchogenic carcinoma, followed by adenocarcinoma (34.29%). In female, adenocarcinoma was the most common type (18;60%) of bronchogenic carcinoma, followed by squamous cell carcinoma (6;20%). Conclusion: FNAC is a safe method for the evaluation of lung nodules and it enables sub-classification of bronchogenic carcinoma in the vast majority of cases. It is also useful for the diagnosis of tuberculous pulmonary nodules. J Enam Med Col 2020; 10(3): 169-173

Evaluation of Computed Tomography Guided Fine Needle Aspiration Cytology of Lung Mass with Histological Correlation

“…Present study showed a higher incidence of adenocarcinoma which was like the study of Stewart CJ, et al 16 and Biswas MMA, et al 19 . However, Gouliamos AD, et al 12 found squamous cell carcinoma as the commonest diagnosis.…”

“…In series based on western populations, TB cases constituted 0.2-1.5% of all FNAC cases for lung nodules 12,22 . In Singapore, TB was found in 5.3% of cases of lung FNAC 19 . In studies from India, the corresponding figures range from 2.1% to 20% 11 .…”

Epidemiological and Cyto-Morphological Spectrum of Pulmonary Lesion by Ct Guided Fnac

“…[11] However, a study conducted by the previous author found more TB cases [7] than this study, which casts some doubt on the lung FNAC method.…”

“…[6] The Evidence suggests that FNAC with CT scan can diagnose malignancy in 93−96.6% cases. [7] 100% specificity for a malignant diagnosis by FNAC with CT scan was reported by Sterrett et al in their thoracic review study. [8] Recently, the diagnostic accuracy is reported to be greater than 80% in benign disease and greater than 90% in malignant disease.…”