Utility of image guided fine needle aspiration cytology in the evaluation of intra-abdominal and retroperitoneal lesions at a tertiary health care center in Kashmir valley

Abstract

Background: FNAC has become an established investigation in the diagnosis of accessible and palpable lesions. Most of the intra-abdominal masses are non-palpable and even if they are palpable, the idea of their size and shape and the extent of the lesion is not possible. Therefore, various imaging modalities like ultra-sonography, computed tomography and fluoroscopy are used as a guide for fine needle aspiration nowadays. Objectives of this study were to assess the utility of image guided fine needle aspiration cytology in the diagnosis of non-palpable intra-abdominal lesions. To study the cytomorphological features of these lesions. To evaluate the sensitivity, specificity and diagnostic accuracy of image guided fine needle aspiration cytology of these lesions.Methods: A prospective study of percutaneous aspiration biopsy of intra-abdominal masses, to evaluate its utility was undertaken in the department of pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir. FNA was performed in 183 patients.Results: Adequate cell sample was obtained in majority of the cases (83.6%). Majority of the abdominal masses were arising from the liver (65%). Location of abdominal masses also included those arising from pancreas (12.02%), kidneys (7.65%), lymph nodes (7.65%), Gall bladder (6%) omental deposits (1.09%) and adrenal gland (0.54%). Majority of US guided FNA was done in liver masses. Overall sensitivity, specificity and diagnostic accuracy of image guided FNAC of intra-abdominal and retroperitoneal masses of the study was 100%, 100% and 93.54%, respectively.Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.

Cytological evaluation of spectrum of Hepatobiliary and Pancreatic mass lesions

“…Shaheena Parveen et al have mentioned 5 such cases with similar cytological features in their study, all of which had a pancreatic primary and eventually underwent resection. 5 There was 1 case of Metastatic GIST in our study. Cellular smears showed singly dispersed and loose clusters of epithelioid tumor cells which formed fascicles with nuclei arranged side-by-side.…”

“…Image guided FNAC is a rapid, cost-effective and safe diagnostic procedure that can be used in various neoplastic and non-neoplastic diseases. 5 It enables exact localization of the lesion, assessment of nature and invasion, multifocality and vascularity of the lesion. The sensitivity and specificity of FNAC of liver in the diagnosis of malignancy is 95% and 100% respectively.…”