Use of fine-needle aspiration biopsy in the evaluation of splenic lesions in a cancer center

Abstract

Fine‐needle aspiration biopsy (FNAB) of the spleen was performed on 50 patients, of whom 40 had had a previous diagnosis of malignancy (23 lymphoproliferative disorders, 13 carcinomas, 3 melanomas, and 1 sarcoma). The cytologic diagnoses included 22 cases positive for malignancy (10 lymphomas, 9 metastatic carcinomas, 2 metastatic melanomas, and 1 sarcoma), 18 cases negative for malignancy, 4 cases suspicious for malignancy, and 6 nondiagnostic specimens. No major complications were associated with the FNAB procedure; however, one patient did develop a pneumothorax that resolved spontaneously. Subsequent splenectomy was performed in 10 of the 50 cases. There were no false‐positive diagnoses, and only one false‐negative diagnosis, which was attributed to sampling error. The aspirate, showing only benign splenic parenchyma, was from a patient with splenomegaly and no previous diagnosis; subsequent splenectomy showed acute myelogenous leukemia. In our study, FNAB proved to be a safe and valuable diagnostic tool for evaluating splenic lesions in oncologic patients. Diagn. Cytopathol. 16:312–316, 1997. © 1997 Wiley‐Liss, Inc.

Laparoscopic splenectomy for solitary splenic tumors

“…Fine-needle aspiration biopsy may be utilized to establish a tissue diagnosis; however, this technique may be associated with bleeding complications and the risk of tumor dissemination [12,13] and therefore, splenectomy is still necessary for diagnostic and therapeutic purposes.…”

“…There are studies about the efficacy and safety of fine-needle biopsy from the spleen, but problems of possible bleeding or tumor dissemination makes the V. Makrin Á S. Avital (&) Á I. White Á B. Sagie Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel e-mail: shmuelavital@hotmail.com A. Szold Endoscopic Surgery Service, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel biopsy problematic [12,13]. This resulted in a tendency to treat any suspected solid tumor of the spleen with splenectomy.…”

Role of aspiration cytology in splenic lesions

“…It has the reputation of being a dangerous intervention and the specimen obtained is usually thought to be unduly difficult to assess, but these prejudicial ideas are fundamentally wrong. [2][3][4][5][6][7][8] FNAC is a safe, easy, simple, reproducible and rapid diagnostic procedure and has distinct advantage over open true cut or core biopsy. As it requires no special instrument and incur no significant trauma and cost to the patient Although radiological modalities like ultrasound, CT scan, or MRI usually narrow down the differential diagnosis but rarely provide a definitive picture and tissue sample in form of an aspirate or a biopsy is required to clinch a specific diagnosis.…”

“…Splenic pathology can be localised or secondary to systemic involvement in various diseases. The indications of splenic FNAC [3][4][5]8,16 are non-neoplastic diseases like infectious diseases, storage disorder, sarcoidosis, amyloidosis, hemophagocytic syndrome and neoplastic conditions like different haematological and metastatic epithelial tumours. In this present retrospective study, we have explored the role of FNAC in splenic lesion in a multidisciplinary tertiary health care centre.…”

“…Splenic pathology can be localised or secondary to systemic involvement in various diseases. The indications of splenic FNAC [3][4][5]8,16 are non- …”