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A Cyto-Histo Correlative Study of Image Guided Fine Needle Aspiration Cytology in Intra-Abdominal Lesions

Dipakkumar R. Prajapati* , Dipakkumar R. Prajapati* , F.R. Shah** , C.K. Shah*** , N.R. Shah****

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Indian Journal of Pathology: Research and Practice 5(3):p 291-296, Sept - Dec 2016. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.5316.9

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Abstract

 Background: Image Guided Fine Needle Aspiration Cytology (Image Guided FNAC) has become routine procedure for any lesion which is deep seated or inaccessible by conventional FNAC. It is an established, simple, rapid, less-invasive and economical procedure for cytological diagnosis of various benign as well as malignant lesions. Aims & Objectives: To study the sensitivity, specificity and diagnostic accuracy of image guided FNAC and to correlate its diagnosis with histopathology (HP) in intra-abdominal lesions. Materials & Methods: Image guided Fine Needle Aspirations (FNA) were performed in 80 patients with various intraabdominal lesions during May 2009 to December 2011. Among which, 73 were USG guided (91.3%) and 7 were CT guided (8.7%). Their cytological diagnosis was compared to HP diagnosis. True and false (positive and negative) data was analyzed to measure sensitivity, specificity and diagnostic accuracy of image guided FNAC. Results: Out of 80 cases, adequate material was aspirated in 75 cases (Sample adequacy 93.6 %.) so remaining 5 cases were excluded from study. Maximum cases were from Liver (24) followed by Ovary (19), Gall bladder (13), Gastro Intestinal Tract (GIT) (10), Lymph nodes (5) and Omentum (4). FNAC was diagnostic in all 75 cases which had adequate material. Among which, 55 (73.3 %) cases were malignant, 9 (12%) were benign and 11 (14.7%) were non-neoplastic. HP correlation was available in 58 (77.3%) cases. HP diagnosis was different from FNAC diagnosis in only 2 (3.4%) cases. Diagnostic accuracy of image guided FNAC was 96.6% with sensitivity of 95.9% and 100% specificity. Conclusion: Having high sensitivity, specificity and diagnostic accuracy, image guided FNAC is an OPD based rapid, reliable and accurate diagnostic procedure for various intra-abdominal lesions which are inaccessible by conventional FNAC. It is much economical to the patient as compared to costly surgical biopsies which have high morbidity.

Keywords: Image Guided FNAC; Intra-Abdominal; Ultrasonography; CT Scan, Histopathological Correlation.

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.5316.9

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