Ultrasound Guided Fine Needle Aspiration Cytology: An Effective Diagnostic  Tool in Pulmonary Medicine

Abdul Rasheed Qureshi; Babar Mumtaz; Zaheer Akhtar; Zeeshan Ashraf; Muhammad Sajid; Muhammad Amir

doi:10.51253/pafmj.v74i3.5076

Authors

Abdul Rasheed Qureshi Department of Pulmonology, Gulab Devi Post Graduate Medical institute Lahore Pakistan, Department of Medicine
Babar Mumtaz Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Zaheer Akhtar Department of Pulmonology, Gulab Devi Post Graduate Medical institute Lahore Pakistan, Department of Medicine
Zeeshan Ashraf Department of Statistics, Gulab Devi Educational Complex, Lahore-Pakistan
Muhammad Sajid Department of Medicine, Gulab Devi Teaching Hospital Lahore Pakistan
Muhammad Amir Department of Pulmonology, Combined Military Hospital Peshawar/ National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i3.5076

Keywords:

Cytology, Efficacy, Fine needle aspiration, Lung, Ultrasound guidance

Abstract

Objective: To evaluate the diagnostic efficacy and safety of fine needle aspiration cytology performed under ultrasound guidance.

Study Design: Comparative prospective study.

Place and Duration of Study: Pulmonology Out-Patient Department, Gulab Devi Teaching Hospital, Lahore Pakistan, from Jun 2018 to Dec 2019.

Methodology: One hundred and twenty-four patients of age 10-80 years, with pulmonary, mediastinal, pleural or chest wall lesions, fulfilling the minimal fitness criteria were included. Aspiration was done by a 23-gauge needle, smear made, and fixed slides were sent to the Cytology Department for evaluation. Complications were monitored. Findings were recorded on preformed proforma.

Results: 121/124(97.6%) aspirates were adequate while 03 cases (2.4%) were reported not representing the lesion. Fifty cases (41.3%) showed malignant cytology, 71/121 aspirates (58.7%) were non-malignant. A specific cell type could be characterized in 84.5% non-malignant and 68.0% malignant aspirates. Complications were a few drops bleeding at needle aspiration site in 7.5 % and minor pain in 12.0 % patients.

Conclusion: Fine needle aspiration cytology under ultrasound guidance is an effective and safe diagnostic tool in pulmonary medicine.

Downloads

Download data is not yet available.

References

Dhillon SS, Harris K. Bronchoscopy for the diagnosis of peripheral lung lesions. J Thorac Dis 2017; 9(Suppl 10): S1047-S1058.

https://doi.org/10.21037/jtd.2017.05.48

Anzidei M, Porfiri A, Andrani F, Di Martino M, Saba L, Catalano C, et al. Imaging-guided chest biopsies: tech-niques and clinical results. Insights Imaging 2017; 8(4): 419-428.

https://doi.org/10.1007/s13244-017-0555-8

Abraham AE, Suresh PK, Sridevi HB, Sahu KK, Adiga D, Minal J, et al. Image-guided fine needle aspiration cytology of intrathoracic lesions. J Cytol 2019; 36(2): 106-110.

https://doi.org/10.4103/JOC.JOC_207_18

Guo Z, Shi H, Li W, Lin D, Wang C, Liu C, et al. Chinese multidisciplinary expert consensus: Guidelines on percutaneous transthoracic needle biopsy. Thorac Cancer 2018; 9(11): 1530-1543. https://doi.org/10.1111/1759-7714.12849

Coley SM, Crapanzano JP, Saqi A. FNA, core biopsy, or both for the diagnosis of lung carcinoma: Obtaining sufficient tissue for a specific diagnosis and molecular testing. Cancer Cytopathol 2015; 123(5): 318-326.

https://doi.org/10.1002/cncy.21541

Singh K, Kotwal S. Importance of image guided fine needle aspiration in diagnosis of benign and malignant lesions. Int J Res Med Sci 2016; 4(2): 512-518.

https://doi.org/10.18203/2320-6012.ijrms20160281

Gupta N, Sekar A, Rajwanshi A. Role of FNAC, fluid specimens, and cell blocks for cytological diagnosis of lung cancer in the present era. J Cytol 2015; 32(4): 217-222.

https://doi.org/10.4103/0970-9371.174711

Sengupta M, Saha K. Computed tomography guided fine needle aspiration cytology of pulmonary mass lesions in a tertiary care hospital: A two-year prospective study. Med J DY Patil Uni 2014; 7(2): 177-181.

https://doi.org/10.4103/0975-2870.126325

Adewoye AB, Lindsay SJ, Dubrova YE, Hurles ME. The genome-wide effects of ionizing radiation on mutation induction in the mammalian germline. Nat Commun 2015; 6: 6684.

https://doi.org/10.1038/ncomms7684

Khosla R, McLean AW, Smith JA. Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions. Lung India 2016; 33(5): 487-492

https://doi.org/10.4103/0970-2113.188961

Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013; 35(2): 121-126.

https://doi.org/10.4103/0253-7176.116232

Sarwar MR, Saqib A, Schumacher U. Cancer prevalence, inci-dence and mortality rates in Pakistan in 2012. Cogent Med. 2017; 4(1). https://doi.org/10.1080/2331205X.2017.1288773

Saha A, Kumar K, Choudhuri MK. Computed tomography-guided fine needle aspiration cytology of thoracic mass lesions: A study of 57 cases. J Cytol 2009; 26(2): 55-59.

https://doi.org/10.4103/0970-9371.55222

Modi MB, Rathva MR, Shah NR, Trivedi M, Patel H. Role of FNAC in lung carcinoma and its histo-cytological correlation. J Lung Plume Respir Res 2016; 3(4): 109-112.

https://doi.org/10.15406/jlprr.2016.03.00090

Mondal SK, Nag D, Das R, Mandal PK, Biswas PK, Osta M. Computed tomogram guided fine-needle aspiration cytology of lung mass with histological correlation: A study in Eastern India. South Asian J Cancer 2013; 2(1): 14-18.

https://doi.org/10.4103/2278-330X.105881

Konjengbam R, Singh NB, Gatphoh SG. Computed tomography guided percutaneous transthoracic fine needle aspiration cyto-logy of pulmonary mass lesions: Two years cross sectional study of 61 cases. J Med Soc 2014; 28(3): 112-116.

https://doi.org/10.4103/0972-4958.144723

Jain D. Tru-cut/core biopsy versus FNAC: Pulmonary tumors. J Cytol 2018; 35(3): 183-186.

https://doi.org/10.4103/JOC.JOC_73_18

Gangopadhyay M, Chakrabarti I, Ghosh N, Giri A. Computed tomography guided fine needle aspiration cytology of mass lesions of lung: Our experience. Indian J Med Paediatr Oncol 2011; 32(4): 192-196.

https://doi.org/10.4103/0971-5851.95139

Pandey DK, Ahmad Z, Masood I, Singh SK, Jairajpuri Z. Role of fine-needle aspiration cytology in evaluating mediastinal masses. Lung India 2009; 26(4): 114-116.

https://doi.org/10.4103/0970-2113.56344

Adler OB, Rosenberger A, Peleg H. Fine needle aspiration biopsy of mediastinal masses. Am J Roentgenol 1983; 140(5): 893-896. https://doi.org/10.2214/ajr.140.5.893

Jareb M, Krasovec M. Transthoracic needle biopsy of media-stinal and hilar lesions. Cancer 1977; 40(3): 1354-1357.

https://doi.org/10.1002/1097-0142(197709)40:3<1354::aid-cncr2820400353>3.0.co;2-y

Madan M, Bannur H. Evaluation of fine needle aspiration cyto-logy in the diagnosis of lung lesions. Turk J Pathol 2010; 26(1): 1-6. https://doi.org/10.5146/tjpath.2010.01017

Sagar RC, Kumar KVV, Madhu SD, Malathi M. A prospective study of number of attempts required in conventional image guided transthoracic fine needle aspiration for pulmonary lesions. Int Surg J 2019; 6(3): 969-974.

https://doi.org/10.18203/2349-2902.isj20190731

Li C, Lu H. Adenosquamous carcinoma of the lung. Onco Targets Ther 2018; 11: 4829-4835.

https://doi.org/10.2147/OTT.S164574

Qureshi AR, Irfan M. Ultrasound guided Sure Cut needle biopsy of peripheral lung and mediastinal lesions for more than 2.0cm size: Efficacy, safety and feasibility - as an outpatient procedure in 179 patients. Isra Med J 2020; 12(4): 178-183.