Abstract

Objective: The aim of present study was to evaluate the role of CT guided FNAC as diagnostic and supportive investigation for the diagnosis of thoracic mass lesions.

Material and Methods: A total of 40 patients of different age groups of both sexes with presentation of thoracic mass lesions were referred from medical and surgical OPD for CT guided FNAC in our department were included in the study. After thorough clinical history, all the patients were subjected to proper clinical examination. Prior to F.N.A.C. all the relevant routine investigation (CBC, ESR, LFT, KFT, BT, CT, Blood Sugar, Viral Markers) were performed and written consent were taken. The transthoracic approach with the patient in supine, prone or decubitus position was used. Aspiration was done by commercially available 20 Gauze, 88 mm long spinal needle. Specimens were immediately smeared on glass slides and air dried for May Grunwald Giemsa stain. Wet fixed smears were stained by Papanicolaou and H&E stains and seen under oil immersion lens.

Results: Out of 40 patients, 32 patients (80%) were males and 8 patients (20%) were females. The age of the patients ranges from 10 years to 75 years. Pulmonary lesion was present in 30 patients (75%) which was the most common site of intrathoracic lesions, 6 patients (15%) had mediastinal lesion whereas 4 patients (10%) had pleural involvement. Almost all the lung tumors were malignant, out of which squamous cell carcinoma has got the highest incidence (25%).

Conclusion: Computed Tomography Guided Fine Needle Aspiration cytology is a simple, safe, highly sensitive and specific procedure with high diagnostic accuracy for diagnosis of intrathoracic mass lesions. The diagnostic sensitivity for malignancy was 97% and specificity 100%. Though our priority was cytological assessment, the cytological diagnosis was corroborated with clinico-radiological parameters and transbronchial biopsies whenever applicable.

Keywords: Transthoracic, CT guided FNAC, Lungs, Mediastinum.