Role of Image-Guided FNAC and Biopsy in Intra-abdominal and Pelvic Masses
Introduction: Intra-abdominal masses present as a conundrum to clinicians. It is essential to determine their pathology before therapy can be instituted. The use of minimally invasive procedures like image-guided Fine Needle Aspiration Cytology (FNAC) and biopsy can help to avoid diagnostic lapa...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2021-01-01
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| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | http://www.njlm.net/articles/PDF/2449/45365_CE[Ra1]_F(SHU)_PF1(ShG_SHU)_PFA(SHU)_PB(ShG_SHU)_PN(SHU).pdf |
| Summary: | Introduction: Intra-abdominal masses present as a conundrum
to clinicians. It is essential to determine their pathology before
therapy can be instituted. The use of minimally invasive
procedures like image-guided Fine Needle Aspiration Cytology
(FNAC) and biopsy can help to avoid diagnostic laparotomy
and is especially important for the diagnosis of impalpable and
deep-seated lesions.
Aim: To find out the pathological spectrum of abdomino-pelvic
masses with use of guided FNAC or biopsy.
Materials and Methods: This was a prospective study
conducted over a period of January 2018 to June 2019 in a
Tertiary Care Hospital in Greater Noida. In patients presenting
with intra-abdominal or pelvic masses, detected clinically or
radiologically, image-guided FNAC and/or biopsy was performed
along with standard radiologic examination, and the slides were
examined. Ultrasonography (USG) was used in 56 cases (96.6%)
and Computed Tomography (CT) for the remaining 2 cases. The
results were analysed using descriptive statistics.
Results: The 58 patients presenting with intra-abdomino-pelvic
masses had a mean age of 49 years and consisted of 30 (51.7%)
males. The most common site involved was liver (19 cases, 32.7%)
followed by gastrointestinal tract (7 cases, 12.1%), urinary bladder
(6 cases, 10.3%), gall bladder and ovary (5 cases, 8.6% each),
kidney, prostate, uterus and lymph node (3 cases, 5.2% each)
and miscellaneous abdomino-pelvic masses (4 cases, 6.9%).
Malignant and premalignant lesions were detected in 50 (86.2%)
patients, of which 29 cases (50%) were primary, 20 (34.5%) were
metastatic and 1 (1.72%) was premalignant. Six benign (10.35%)
and 2 non-neoplastic (3.45%) lesions were detected. Malignancies
were found most commonly in the liver, comprising 31.0% of the
study group. Adenocarcinoma was the most commonly detected
primary (15 cases, 25.8%) as well as secondary metastatic
malignancy (12 cases, 20.7%). Radio-pathological correlation was
found to be 79.3% for the study and varied according to the site,
from zero in prostatic lesions to 100% in renal and uterine lesions.
Radiologic concordance was observed in 100% non-neoplastic,
66.7% benign and 72.4% malignant lesions.
Conclusion: Image-guided FNAC and biopsy are simple, rapid
and inexpensive methods of arriving at a definite diagnosis, as
radiology alone proves to be inadequate or erroneous in most
of the cases. |
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| ISSN: | 2277-8551 2455-6882 |