USG guided FNAC of ovarian mass lesions: A cyto-histopathological correlation, with emphasis on its role in pre-operative management guidelinesö

Abstract

Objective: Ultrasonography (USG)-guided fine-needle aspiration cytology (FNAC) of ovarian masses is an efficient diagnostic modality for accurately diagnosing ovarian tumours prior to surgery. The main aim of this study was to assess the sensitivity, specificity and accuracy of FNAC in diagnosing ovarian masses. Material and Methods:Eighty-three patients with ovarian masses were recruited and correlation of USG-guided FNAC was made with histopathology in all but 6 cases, where surgery was not indicated. Results:Cytological diagnosis was obtained in all 83 ovarian lesions: 56 cases were benign, 6 possibly benign, 3 suspicious of malignancy and 18 cases as malignant. Out of 77 cases where histology was available, the 12 non-neoplastic cysts were endometriotic cysts and follicular cysts. The majority of neoplastic lesions were surface epithelial tumours. Out of 12 non-neoplastic cysts and 43 benign tumours, all but two were diagnosed as benign or possibly benign on cytology; of the 22 histologically malignant or borderline tumours, 18 were malignant or suspicious of malignancy on cytology, while four were false negative (three of these were borderline tumours). Thus, the sensitivity of cytological diagnosis was 83%, specificity was 97% and accuracy was 93%.Conclusion: USG-guided FNAC seems to be a relatively safe, simple, fast and cost-effective procedure where most ovarian malignancies either present late in their course or no screening method is available. In addition, cyto-radiological correlation through this procedure may be useful in deciding management guidelines prior to any surgical intervention. (J Turk Ger Gynecol Assoc 2014; 15: 6-12) Key words: Ultrasound, fine-needle aspiration cytology, ovarian mass, image-guided, cytology Received: 31 October, 2013 Accepted: 19 December, 2013 USG guided FNAC of ovarian mass lesions: A cyto-histopathological correlation, with emphasis on its role in pre-operative management guidelines

Computed Tomography And Ultrasound Guided Fine Needle Aspiration Cytology In The Diagnosis Of Intraabdominal And Pelvic Lesions

“…Aspiration from the ovarian in suspected ovarian malignancies is a matter of concern to several clinicians due to advertent seeding of the needle track. However, studies by Ray et al [9] have refuted claims of such seeding of early stage of ovarian carcinoma while aspirating ovarian lesions. The authors believe that USG guided FNAC is safe and efficacious in the diagnosis of ovarian malignancies.…”

A systematic review of ultrasonography-guided transvaginal aspiration of recurrent ovarian endometrioma

“…It is also used as a minimally invasive method for the differential diagnosis of ovarian diseases. The cytology of the aspirate of an ovarian lesion has a sensitivity of 83% and a specificity of 97% for malignant tumors, follicular cysts, and ovarian endometriomas [14]. As far as we are aware, there are no reports in the literature concerning the accuracy of the International Journal of Gynecology and Obstetrics 134 (2016) [3][4][5][6][7] diagnosis of ovarian endometrioma using ultrasonography-guided transvaginal aspiration.…”

Fine-Needle Aspiration Biopsies of Ovarian Masses: A Reliable Technique

“…However, when we followed the pathology results of these cases, 8 happened to be benign cysts. Therefore, as was also mentioned in the study by Ray et al [6], these cases should not be labeled as insufficient. Although this statement may be true, it is not applicable to every hypocellular case because aspiration of the cyst fluid in tumors with a solid and cystic component may result in false negative cytology.…”

“…During laparotomy for suspected unilateral diseases, FNA may provide sufficient data about the opposite ovary to allow that organ to remain in place, thus preserving its function in a young patient. It is also indicated for initial evaluation before treatment and may be beneficial in recurrent or metastatic tumors in premenopausal women [6]. …”