A study of ultrasound- guided FNAC in abdominal masses

Abstract

Aims and Objectives: The present study was undertaken to assess accuracy, feasibility and safety of radiologically guided FNAC of intra-abdominal and retroperitoneal masses.

Methods: This prospective study was conducted in the Department of Pathology, in collaboration with the Department of Radiology, at Government Medical College, Nagpur. Ultrasound-guided percutaneous FNAC were performed on 273 patients, for pathologic confirmation of a suspected tumor, secondary metastasis or an infective etiology.

Results : The liver was most predominant site (35.53%) of abdominal masses. Of total 217 (79.48%) adequate smears, malignancy was reported in 179 (82.4%) cases, benign in 7 (3.2%) cases and inflammatory in 19 (8.8%) cases. 12 (5.6%) cases were suspicious of malignancy. Secondary metastasis in liver was commonly detected lesion comprised of 16.2% of total malignant abdominal masses followed by hepatocellular carcinoma 15%. A correlation between clinic-radiologic impression and cytologic diagnosis was obtained in 213 cases. FNAC changed clinic-radiologic diagnosis in 4 cases. A cyto-histopathologic correlation was obtained in 58 cases. An overall accuracy of 98.3% was achieved by ultrasound guided FNAC, with a sensitivity of 98% and a specificity of 100%. Predictive value for positive and negative was found to be 100% and 87.50% respectively. No more than 2 cases were made into any lesion.

Conclusion: Ultrasound guided percutaneous FNAC is a very valuable diagnostic tool in terms of higher degree of both accuracy and adequacy with low incidence of complications. In addition, it has a high sensitivity and specificity contributing to a more efficient diagnosis and treatment planning of the patient.