CT Guided Transthoracic FNAC of Intrathoracic Lesions-An Institute Experience
Introduction: In the management of thoracic lesions, especially malignant lesions, specific pathological diagnosis is considered standard, so obtaining the tissue is essential for diagnosis and treatment. There are complex vascular structures in hila and mediastinum and so precise localization...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2018-07-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/article_fulltext.asp?issn=0973-709x&year=2018&month=July&volume=7&issue=3&page=RO47-RO54&id=2418 |
| Summary: | Introduction: In the management of thoracic lesions,
especially malignant lesions, specific pathological diagnosis
is considered standard, so obtaining the tissue is essential
for diagnosis and treatment. There are complex vascular
structures in hila and mediastinum and so precise localization
is necessary to avoid unnecessary injury to these structures,
which can be achieved by doing image guided procedures.
Aim: This study was proposed to analyze the role of CT in
guiding the FNAC of the thorax and to understand its scope
in improving the diagnostic accuracy and therapeutic
outcome, decreasing the patient discomfort, cost and
surgical morbidity and also in assessing the types of
complications arising out of the same.
Materials and Methods: This prospective observational
study was conducted at Kidwai Memorial Institute of
Oncology Bengaluru, India, from 2012 to 2015 for three
years. This study consisted of 420 patients who were
referred for TTFNAC.
Results: The Study consisted of 420 patients in age group of
18-87 years. Total yield of 85% was achieved, complications
were seen in 126 patients (20%)in the form of pneumothorax
and hemorrhage. Maximal lesions encountered were seen
in the lungs, followed by mediastinum. The sensitivity
specificity, positive and negative predictive values are 97%,
66%, 94% and 82% for malignant lesions. However, it was
lower for benign lesions.
Conclusion: CT-guided Transthoracic (TTFNAC) is a good
tool for material procurement in benign and malignant
lesions. It helps the clinician to initiate appropriate treatment
measures like chemotherapy or radiotherapy at an early pace
and is associated with low mortality and morbidity. TTFNAC
achieves substantial cost savings, as it can obviate more
costly and invasive surgical procedures and is minimally
invasive. Fewer complications are caused by TTFNAC that
can be avoided, if properly planned by avoiding vessels and
bullae. However, if they occur they can be easily managed.
This procedure can be used as a safe outpatient procedure
for material procurement in lung or mediastinal lesions, not
accessible for ultrasound guided FNAC, for lesions situated
less than 8 cm from chest wall and size greater than 25 mm
and it has good patient tolerance. |
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| ISSN: | 2277-8543 2455-6874 |