Ultrasound Gu Ided Transthoracic Fine Needle Aspiration Cytology in Diagnosing Peripheral Pulmonary Lesions

Abstract

BACKGROUND:A non-resolving opacity on chest X-ray despite intensive pharmacotherapy poses a diagnostic problem for the clinician. Transthoracic Fine Needle Aspiration Cytology is regarded as the most effective of the cytological methods for diagnosing lung cancer, in particular peripherally-located lesions including lung nodules of infective etiology. In this study we evaluated the role of ultrasound guided percutaneous Fine Needle Aspiration Cytology in various peripheral pulmonary lesions. MATERIALS AND METHODS: Eighty one (81) Patients with peripheral lung lesions who were admitted in the Department of pulmonary medicine, Guntur Medical College/Government Fever Hospital, Guntur from January 2014 to March 2015. RESULTS: Out of 81 patients, diagnostic yield was obtained in 71 patients. In 71 patients, 45patients (55.5%) were with malignant and 26(32%) were with non-malignant lung lesions. Out of 45 malignant patients, Squamous cell carcinoma was seen in 27 patients (60%) followed by Adenocarcinoma in 10 (22.22%), Large cell carcinoma in 07(15.55%) and Metastatic carcinoma in 01 patient (2.22%). Out of 26 non-malignant lung lesions, 18 patients were with Tuberculosis (69.23%) and 08 patients were with pneumonia (30.76%). CONCLUSION: Ultrasound Guided Trans-thoracic FNAC of peripheral pulmonary lesion is, simple, safe, quick, acceptable, easily accessible, accurate and cost-effective procedure without radiation. It lessens the need of other procedures like BAL, FOB and cutting biopsy procedures etc. KEYWORDS: FNAC, Lung Cancer, Peripheral Lung Lesion, Pneumonia, Tuberculosis, Ultrasound. INTRODUCTION:A non-resolving opacity on chest X ray despite intensive pharmacotherapy poses a diagnostic problem for the clinician (1) . Radiographic features such as size, location of the lesion, margins, shape, growth rate and presence of calcification are helpful for the diagnosis, and are not confirmative. Fine Needle Aspiration Cytology (FNAC) is a well-established method of diagnosing both neoplastic and inflammatory conditions of the lung, has resulted in a decrease in the need of other procedures that are more invasive. Transthoracic Fine Needle Aspiration Cytology is regarded as the most effective of the cytological methods for diagnosing lung cancer, in particular peripherallylocated lesions including lung nodules of infective etiology. Trans-bronchial lung biopsy or brushings via Fibre Optic Bronchoscope and Per-cutaneous transthoracic aspiration under fluoroscopic guidance are the other alternatives. Diagnostic methods which are time consuming and not available in all centers. In such cases Ultrasound guided Fine Needle Aspiration Cytology of peripheral pulmonary lung lesions using fine needle is the choice for establishing the diagnosis which is simple and safe. Real time B-mode ultra-sonography which is readily available in most centers is easy to perform and free from radiation, helps in the evaluation of pulmonary lesions and also the needle can be guided under vision and aspirates can be obtained from d...

Role of Computed Tomography-guided Fine-needle Aspiration Cytology/Biopsy in Management of Lung Lesions: Experience of a Tertiary Care Oncology Hospital

“…11 Radiological imaging is used to describe the morphological characteristics of the lesions; however, characterization is not always possible due to overlapping of the features. [12][13][14] Fine-needle aspiration cytology can help in differentiating benign, malignant, and infectious pathologies, whereas biopsy can help in formulating the histopathological diagnosis. This helps in guiding the treatment, like surgery, chemotherapy, and radiotherapy.…”