A Critical Appraisal of the Spectrum of Image Guided Fine Needle Aspiration Cytology: A Three Year Experience from a Tertiary Care Centre in Delhi

Objective: Image guided fine needle aspiration cytology (FNAC) is a safe, simple, rapid, cost effective and accurate modality in evaluation of deep seated lumps (abdominal, pelvic and intrathoracic masses) which are unapproachable by blind FNAC. In this study, a critical analysis of the utility of image guided FNAC in deep seated and otherwise inacessible mass lesions was carried out. Material and Method: Fifty-four ultrasound (USG) or computed tomography (CT) guided FNACs from lumps at any location in the body, that is, thoracic, abdominal, pelvic etc over a period of 3 years (January 2012-December 2014) were included in the study. The most common site aspirated, the indications for a guided aspiration and the accuracy of aspiration cytology in comparison to the histological diagnosis were evaluated, wherever possible. Results: Fifty-four image guided FNACs were performed (46 USG guided and 8 CT guided). Inconclusive, inflammatory, benign tumors, suspicious and malignant lesion rates were 5.6%, 29.6%, 11.1%, 5.6%, and 48.1%, respectively. The most common site was the liver (25.5%), followed by the thyroid (18.5%), lung (14.8%), gallbladder (11.1%), and lymph nodes (7.4%). Cytohistological correlation could be performed in 32 cases with a diagnostic accuracy of 100%. Conclusion: FNAC coupled with a diagnostic imaging technique such as USG or CT can improve the diagnostic yield and a definite diagnosis can be reached in most of the cases.