Image-Guided Fine Needle Aspiration Cytology of Pulmonary Lesions at a Tertiary Care Hospital

Diya  Bajaj,; Manish Kumar  Gupta,; Jitendra Kishor  Bhargava,; Jitin  Bajaj,

Image-Guided Fine Needle Aspiration Cytology of Pulmonary Lesions at a Tertiary Care Hospital

Diya Bajaj | Manish Kumar Gupta | Jitendra Kishor Bhargava | Jitin Bajaj

Abstract:

Lung cancer is the leading cause of cancer-related mortality worldwide. Patients usually present at an advanced stage, so early diagnosis is important for better prognosis and management. Ultrasound-guided fine needle aspiration cytology (FNAC) is the diagnostic procedure of choice in lung lesions for timely diagnosis and better prognosis. Our study aimed to determine the specificity and sensitivity of FNAC in the diagnosis of pulmonary tumors and to assess the morphological features of various lung tumors. A retrospective study was carried out from June 2020 to August 2021 at a tertiary care center in Jabalpur, Madhya Pradesh, India. A total of 81 cases presenting with clinical and radiological features suggestive of lung malignancies were studied. Image-guided FNAC was done in all cases, and smears were stained using PAP and Giemsa stain. Typing was conducted on cytological evaluation, and histopathological correlation was obtained wherever possible. Immunohistochemistry was performed in a few cases where necessary. Eighty-one cases of ultrasound-guided FNAC of lung lesions were studied. Lung cancers were found to be more common in males, with a male-to-female ratio of 5.75:1, and the mean age at presentation was 55 years. Neoplastic lesions were 86.41%, and nonneoplastic lesions were 7.40%. Squamous cell carcinoma (60.49%) was found to be most common malignancy, followed by adenocarcinoma (11.11%) and small cell carcinoma (8.64%). Diagnostic specificity and sensitivity of FNAC were 100% and 95.65%, respectively. Image-guided FNAC is a safe, rapid, inexpensive, highly sensitive, and specific diagnostic procedure with fewer complications when performed by trained personnel. It helps in the early diagnosis and management of patients with pulmonary lesions leading to a better prognosis.

References:

Muley, S.; Munje, R.; Gour, S.; Atram, J. Diagnostic yield of various procedures in lung cancer. J Med Sci Clin Res 2017, 9, 27658-27661.
Abraham, A.E.; Suresh, P.K.; Sridevi, H.B.; Sahu, K.K.; Adiga, D.; Minal, J. Image-guided fine needle aspiration cytology of intrathoracic lesions. J Cytol 2019, 36, 106-110.
Mullan, C.P.; Kelly, B.E.; Ellis, P.K. CT–guided fine–needle aspiration of lung nodules: Effect on outcome of using coaxial technique and immediate cytological evaluation. Ulster Med J 2004, 73, 32–36.
Cox, J.E.; Chiles, C.; McManus, C.M. Transthoracic needle aspiration biopsy: Variables that affect risk of pneumothorax. Radiology 1999, 212, 165–168.
Modi, M.; Rathva, M.; Shah, N.; Trivedi, M.; Patel, H. Role of FNAC in lung carcinoma and its histo-cytological correlation. J Lung Plume Respir Res 2016, 3, 109‒112.
Mukherjee, S.; Bandyopadhyay, G.; Bhattacharya, A; Ghosh, R; Barui, G.; Karmakar, R. Computed tomographyguided fine needle aspiration cytology of solitary pulmonary nodules suspected to be bronchogenic carcinoma: Experience of a general hospital. J Cytol 2010, 27, 811.
Roohi, M.; Haque, A.U. Transthoracic fine needle aspiration cytology in lung masses. Int J Pathol 2009, 7, 3442.
Shah, S.; Shukla, K.; Patel, P. Role of needle aspiration cytology in diagnosis of lung tumors: A study of 100 cases. Indian J Pathol Microbiol 2007, 50, 56–58.
Saha, A.; Kumar, K.; Choudhuri, M.K. Computed tomography–guided fine needle aspiration cytology of thoracic mass lesions: A study of 57 cases. J Cytol 2009, 26, 55–59.
Konjengbam, R.; Singh, N.B.; Gatphoh, S.G. Computed tomography guided percutaneous transthoracic fine needle aspiration cytology of pulmonary mass lesions: Two years cross sectional study of 61 cases. J Med Soc 2014, 28, 112116.
Mondal, S.K; Nag, D.; Das, R.; Mandal, P.K.; Biswas, P.K.; Osta, M. Computed tomogram guided fineneedle aspiration cytology of lung mass with histological correlation: A study in Eastern India. South Asian J Cancer 2013, 2, 1418.
Prashant; Ramachandra, C.; Pattbhiraman; Raghuram; Attili, V.S. Feasibility, safety, and efficacy of the CT guided fine needle aspiration cytology (FNAC) of lung lesions. Indian J Med Paediatr Oncol 2007, 28, 16 25.