TMSS Medical College Journal

Background: Computed tomography (CT)-guided fine needle aspiration cytology (FNAC) is regarded as a rapid, safe, and accurate diagnostic aid in lung lesions. Aims: To assess the role of CT-guided FNAC in thoracic mass lesions, to analyse the results, and to compare the results with other studies. Materials and Methods: ninety two patients were studied over two year (January 2018- December 2019) for their cytological diagnoses. Results: Out of 92 cases, 46(50%) cases are diagnosed as malignant. There were 41 parenchymal (lung) tumors and the remaining four tumor cases were mediastinal and one case involved chest wall. The most common tumor was adenocarcinoma (39.1%) followed by squamous cell carcinoma(28.3%) and small cell carcinoma(13%). Post procedural complications were minimal and were noted in only three cases (a little pulmonary hemorrhage in two and hemoptysis in one). Conclusion: CT-guided FNAC is an extremely valuable and fairly accurate diagnostic aid of intrathoracic mass lesions, with a reasonable rate of complication.

Fine Needle Aspiration Cytology (FNAC) introduced first by Soderstrom in 1952, then it has become a well-established, outpatient procedure used worldwide in the primary diagnosis of any palpable swellings." It is quick, cost-effective and minimally invasive technique distinguishes between benign and malignant lesions quite effectively. However, its application is limited in cases with deep seated lumps, smaller sized lesions which are not readily palpable or if a small swelling is present in a crucial location, adjacent to major vessels. In such case scenarios, FNAC coupled with diagnostic imaging techniques such as ultrasound (USG) or computed tomography (CT) can improve the diagnostic yield and a definite diagnosis can be reached in most of the cases. Transthoracic percutaneous needle biopsy (PNB) is routinely used to diagnose parenchymal®” and accessible mediastinal*'* neoplasms. Recognition of the high accuracy rate of FNAC along with the simpler methods to treat its complications like pneumothorax has increased its popularity among clinicians, radiologists and pathologists.'*'* Even though FNAC has proven its role in the diagnosis of infections and other diffuse benign processes, the main indication remains the diagnoses of localized intrathoracic lesions suspected of being malignant, particularly when less-invasive investigations prove to be negative. The presence of pathologist at the time of the procedure leads to a reduction in the number of needle passes and may increase the overall sensitivity and accuracy of tumor typing.'™'® The purpose of this present study was to evaluate the effectiveness of Computerized Tomography (CT) guided FNAC in the diagnosis of pulmonary lesions and to analyze the age, sex, and topographic distribution, and cytopathological diagnosis of thoracic