Shah Vinaya B, Shet Tanuja M, Lad Shilpa K
Department of Pathology, TN Medical College & B Y L Nair Hospital, Mumbai, India.
J Cytol. 2011 Jul;28(3):103-7. doi: 10.4103/0970-9371.83463.
The incidence of non neoplastic lesions are much more common in epididymis. Clinically, epididymal nodules are easily accessible to fine needle aspiration cytology (FNAC) procedure. There are very few literature reports documenting the role of cytology in evaluation of epididymal nodules. Thus, we studied patients presenting with palpable epididymis nodules in the out patient department (OPD) from a tertiary care general hospital.
This study is aimed to put forth the diagnostic utility of FNAC in palpable lesions of epididymis.
A total of 40 palpable epididymal nodules were aspirated as a routine OPD procedure as part of this study. Smears were fixed in isopropyl alcohol and air dried. In all the cases, wet fixed papanicoloau stained and air dried giemsa stained smears were studied. Zeihl Neelsen stain was performed in cases which yielded caseous aspirate.
Except for two cases of adenomatoid tumor of epididymis all other lesions were nonneoplastic and included 14 cases (35%) of tuberculous granulomatous inflammation, 10 (25%) cystic nodules (9 spermatoceles and 1 encysted hydrocele), 5 (12.5%) of nonspecific inflammations, 3 (7.5%) filarial infection, 3 (7.5%) sperm granulomas and 3 (7.5%) adenomatous hyperplasia of rete testes. Except for the two tumors, one adenomatous hyperplasia and one tuberculous lesion, no other lesion was excised. Follow up and response to therapy was available in 78% patients and resolution indicated appropriateness of the diagnosis
Thus, as most of the lesions in epididymis are non neoplastic responding to medical line of treatment and FNAC served to aid diagnosis of non specific inflammation and avoid surgical excision in most cases.
非肿瘤性病变在附睾中更为常见。临床上,附睾结节易于进行细针穿刺细胞学检查(FNAC)。关于细胞学在评估附睾结节中的作用,文献报道极少。因此,我们对一家三级综合医院门诊出现可触及附睾结节的患者进行了研究。
本研究旨在阐明FNAC在可触及的附睾病变中的诊断效用。
作为本研究的一部分,共对40个可触及的附睾结节进行了穿刺,这是一项常规门诊操作。涂片用异丙醇固定并风干。所有病例均研究了湿固定巴氏染色和风干吉姆萨染色的涂片。对产生干酪样吸出物的病例进行了齐-尼氏染色。
除2例附睾腺瘤样肿瘤外,所有其他病变均为非肿瘤性,包括14例(35%)结核性肉芽肿性炎症、10例(25%)囊性结节(9例精子囊肿和1例包囊性鞘膜积液)、5例(12.5%)非特异性炎症、3例(7.5%)丝虫感染、3例(7.5%)精子肉芽肿和3例(7.5%)睾丸网腺瘤样增生。除2例肿瘤、1例腺瘤样增生和1例结核病变外,未切除其他病变。78%的患者有随访及治疗反应情况,病情缓解表明诊断正确。
因此,由于附睾中的大多数病变为非肿瘤性,对药物治疗有反应,FNAC有助于诊断非特异性炎症,且在大多数情况下可避免手术切除。