Computed Tomography Correlation of Thoracic Lesions with Transthoracic Fine Needle Aspiration Cytology And Biopsy

Abstract

Introduction: The study is an attempt to evaluate the sensitivity,
specificity, positive predictive value, negative predictive value,
p-value, and complications of CT guided thoracic interventions
fine needle aspiration cytology and core biopsy, which are used
for diagnosing benign and malignant thoracic lesions.
Material and Methods: The study included 102 patients
(87 males and 15 females) with age group ranged from 15 to 87
years. A total of 143 CT guided interventions (84 FNAC’s and
59 core biopsies) were performed in 102 patients. The tissue
obtained was sent to the laboratory for histopathological and
cytological analysis for a final diagnosis, which would contribute
to patient management.
Results: A ll 5 9 c ore b iopsies w ere s uccessful i n p rocuring
adequate tissue for histopathological analysis and the yield of
core biopsies was 100%. However, out of 84 FNAC’s, only four
were unsuccessful in procuring adequate tissue with a failure
rate of 4.8%. Postprocedural biopsy complications were only
three (2.1%), which were small pneumothorax. There were 75
malignant lesions and 23 benign lesions based on cytology,
and histopathology (4 were excluded due to inadequate
sample). There was good agreement between benign and
malignant lesions diagnosed on CT and that diagnosed by
pathology. The most common benign and malignant lesions
were granulomatous lesion and squamous cell carcinoma.
Conclusion: Percutaneous CT guided interventions like
core biopsy and fine-needle aspiration cytology are simple
minimally invasive procedures with good patient acceptance
and low morbidity and almost negligible mortality. CT guided
interventions should be performed early for diagnosis of
thoracic lesions.