Value of ultrasound-guided fine-needle aspiration in the management of ovarian and paraovarian cysts

Abstract

This study was designed to assess if cytology was accurate for an appropriate diagnosis of ovarian and paraovarian cysts, and if the ultrasound‐cytology‐estradiol (UCE) triad was sufficient to discriminate functional vs. nonfunctional cysts, the latter requiring surgical resection. One hundred twenty‐two ultrasound‐diagnosed adnexal cysts were punctured and surgically removed, and then subjected to cytologic and histologic examinations; 90 of these fluids were assayed for estradiol. Histologically, 30 cysts were functional and 92 were nonfunctional. A correct discrimination between functional and nonfunctional origin was obtained in 54.9% of cases with cytology, in 94.4% with estradiol assay, in 50.8% with ultrasonography, and in 97.8% with these three examinations combined (UCE triad). Among the 34 patients with no criteria of neoplastic origin (age >40, ultrasonographic findings), the UCE triad diagnosed six functional cysts. Therefore, 17.6% (6/34) of these young women could have avoided unnecessary surgery. Diagn. Cytopathol. 2000;22:70–80. © 2000 Wiley‐Liss, Inc.

Evaluation of aspiration cytology of ovarian masses with histopathological correlation

“…Even though all 10 cases of teratoma were correctly diagnosed in this study, other studies have shown results varying from 30% to 100% 1,23,24 . The presence of hair shafts in teratoma has been described as being exceptional 24 . All seven cases (100%) of mucinous cystadenoma were correctly classified, similar to the result obtained in another study where 29 of 30 cases (96.7%) were diagnosed 23 .…”

“…Even though all 10 cases of teratoma were correctly diagnosed in this study, other studies have shown results varying from 30% to 100% 1,23,24 . The presence of hair shafts in teratoma has been described as being exceptional 24 .…”

Ovarian needle aspiration in the diagnosis and management of ovarian masses

“…In prior studies, sensitivity rates of ovarian aspiration and needle biopsy varied widely from 25% to 100% [56789101112131415161718192021222324252627]. We reported sensitivity of ovarian needle biopsy to be 75%, which is within the range of prior studies.…”

“…False negativity has been attributed to multiple factors, including insufficient or low specimen cellularity [6781012151617202122], borderline ovarian tumors [31214202123], sampling error [513], cellular degeneration [1518], interpretation error [17] and ovarian surface involvement by metastatic carcinoma [20]. Insufficient or low cellularity of cystic samples was the most commonly reported cause of false negative results, rendering the specimen non-diagnostic in 17%–43% of studies [678101112151617202122]. Borderline tumors may be difficult to diagnose on cytologic examination because the neoplastic cells show less cellular atypia than frank carcinomas [31214202123].…”

Die transvaginale Behandlung von Ovarialzysten mittels Alkoholsklerosierung

“…Im Rahmen des Eingriffs konnten keine Besonderheiten an den Ovaren beobachtet werden. [20]. Das Inhibin aus der aspirierten Flüssigkeit kann ebenfalls bestimmt werden zum Nachweis von Granulosazellen aus funktionellen Zysten [21,22].…”