Abraham Annie E, Suresh Pooja K, Sridevi H B, Sahu Kausalya K, Adiga Deepa, Minal Jessica, Rai Santosh, Acharya Vishak
Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India.
Department of Cytogenetics, HCG Hospital, Bengaluru, Karnataka, India.
J Cytol. 2019 Apr-Jun;36(2):106-110. doi: 10.4103/JOC.JOC_187_17.
Percutaneous, image-guided transthoracic fine needle aspiration cytology (TTFNAC) is a rapid, yet accurate, and well-established diagnostic method used in the cytological evaluation of intrathoracic lesions. The study was done to determine the utility of image-guided TTFNAC in diagnosis of intrathoracic lesions.
A retrospective analysis of all cases who underwent image-guided TTFNAC of a suspected intrathoracic lesion, in a tertiary care hospital was done over a period of 3 years.
During the study period, 124 cases of image-guided FNAC of intrathoracic lesions were obtained. The mean age at presentation was 60.5 years with M:F: 3.6:1. Neoplastic lesions (71.5%) outnumbered the nonneoplastic lesions (28.5%). The most common tumor was adenocarcinoma (25%) followed by squamous cell carcinoma (SCC, 11%), and small cell carcinoma (5%). There was one case each of anaplastic carcinoma, plasmacytoma, bronchoalveolar carcinoma, and non-Hodgkin lymphoma (NHL). Most of the lesions were found on the right side and upper lobe. Among the mediastinal lesions, we found two cases of thymoma and one case each of NHL)/primitive neuroectodermal tumor (PNET), NHL, and small cell carcinoma metastasis to lymph node followed by ten cases of inflammatory lesions and seven cases of tuberculosis (TB).
Image-guided TTFNAC of intrathoracic lesions is a safe method when done by well-trained medical personnel with lesser rate of complications. An early accurate diagnosis of malignancy can be made based on the cytological features; however, further subtyping of the malignancy may sometimes be difficult due to overlapping cytological features. TTFNAC can be a diagnostic tool for identifying nonneoplastic lesion such as TB. Hence, image-guided FNAC aids in early diagnosis and management of patients with intrathoracic lesions.
经皮影像引导下经胸细针穿刺抽吸细胞学检查（TTFNAC）是一种快速、准确且成熟的诊断方法，用于胸腔内病变的细胞学评估。本研究旨在确定影像引导下TTFNAC在胸腔内病变诊断中的效用。
对一家三级医院3年内所有接受影像引导下对疑似胸腔内病变进行TTFNAC检查的病例进行回顾性分析。
在研究期间，共获得124例影像引导下胸腔内病变的细针穿刺抽吸检查结果。就诊时的平均年龄为60.5岁，男性与女性比例为3.6:1。肿瘤性病变（71.5%）多于非肿瘤性病变（28.5%）。最常见的肿瘤是腺癌（25%），其次是鳞状细胞癌（SCC，11%）和小细胞癌（5%）。间变性癌、浆细胞瘤、支气管肺泡癌和非霍奇金淋巴瘤（NHL）各有1例。大多数病变位于右侧和上叶。在纵隔病变中，我们发现2例胸腺瘤，NHL/原始神经外胚层肿瘤（PNET）、NHL和小细胞癌转移至淋巴结各1例，其次是10例炎症性病变和7例结核病（TB）。
由训练有素的医务人员进行影像引导下胸腔内病变的TTFNAC是一种安全的方法，并发症发生率较低。基于细胞学特征可早期准确诊断恶性肿瘤；然而，由于细胞学特征重叠，有时恶性肿瘤的进一步亚型分类可能会很困难。TTFNAC可作为识别TB等非肿瘤性病变的诊断工具。因此，影像引导下细针穿刺抽吸有助于胸腔内病变患者的早期诊断和治疗。
