Ultrasound-guided aspiration cytology of retroperitoneal masses with histopathological corroboration: A study of 71 cases

Abstract

Background:Diagnosis of retroperitoneal lesions is one of the most difficult areas in surgical pathology. Both primary and metastatic tumors can grow silently in retroperitoneum before the appearance of clinical signs and symptoms. Guided aspiration cytology has shown a promising role in diagnosis of lesions in this region.Aims:This study was undertaken to evaluate the reliability of guided fine-needle aspiration cytology (FNAC) in the diagnosis of retroperitoneal masses and to study the spectrum of retroperitoneal lesions in a rural tertiary care hospital.Materials and Methods:This study was done on 71 patients presenting with retroperitoneal masses over a period of 20 months in a tertiary care hospital. Ultrasound-guided FNAC was done and the smears were stained by MGG and H and E stains. Histopathological corroboration could be done on all neoplastic lesions along with some non-neoplastic lesions.Results:Out of 71 cases, 48 cases (67.6%) were found to be neoplastic. Malignant tumors (35 cases) were more common than benign ones (13 cases). Malignant lesions were predominantly composed of lesions of lymph node (17 cases i.e. 48.57%) followed by sarcomas (5 cases) and germ cell tumors. Some uncommon retroperitoneal lesions like adrenal myelolipoma, renal angiomyolipoma, Burkitt's lymphoma and adrenocortical carcinoma were found in our study. Guided FNAC could diagnose all the malignant lesions with 100% accuracy except in 2 cases of poorly differentiated carcinoma which came out to be non-Hodgkin lymphoma on subsequent biopsies.Conclusion:Guided FNAC is an inexpensive, rapid and reliable method for diagnosis of retroperitoneal masses.

Fine needle aspiration in retroperitoneal lesions

“…Similar to other studies, we also observed a male predominance in our cases with a male to female ratio of 1.5:1. In all of the previously reported studies, malignant lesions were more common than benign and non‐neoplastic lesions . In our study, most commonly encountered retroperitoneal lesions were pancreatic masses (n = 113).…”

“…In a study by Chakarbarty et al on 71 patients with retroperitoneal masses, retroperitoneal lymphadenopathy was the most common lesion. The patient age ranged from 1.5 to 75 years with 44 males and 27 females . The patients’ age, in the present study, ranged from 1 to 88 years with majority of the patients being more than 50 years of age (49%; n = 192).…”

“…Few studies have evaluated the role of FNAC in retroperitoneal lesions . In a study by Misra et al , the most common site for retroperitoneal lesions was kidney (52.6%).…”

Role of guided Fine needle aspiration cytology in diagnosis of abdominopelvic masses

“…In the malignant soft tissue lesions, there were two cases of pleomorphic sarcoma (MFH), one each of leimyosarcoma, liposarcoma, small round cell tumor and NHL. Mangal et al [19] and Chakrabarti et al [20] also found MFH to be most frequently encountered sarcoma. Fibromatosis was most common lesions among benign retroperitoneal proper masses which was different from Mangal et al [19] and Chakrabarti et al [20] in which lipoma was most common benign lesion.…”

“…Mangal et al [19] and Chakrabarti et al [20] also found MFH to be most frequently encountered sarcoma. Fibromatosis was most common lesions among benign retroperitoneal proper masses which was different from Mangal et al [19] and Chakrabarti et al [20] in which lipoma was most common benign lesion. Although few studies have reported complications like mild local pain, bleeding and tumor seeding of the needle tract but most of the literature supports the safety of FNAC.…”