Sweta Sinha

Abstract

Background: Real time ultrasound guided fine needle aspiration cytology (FNAC) of non-palpable, intraabdominal and intra-pelvic masses are easily performed and reported rapidly. Needle tip can be visualized and manipulated on real time aspirations. It increases the sensitivity due to high diagnostic yield from target areas. Materials and Methods: The present study is a retrospective study of 161cases, where real time ultrasound guided FNAC of intra-abdominal and intra-pelvic masses were done from 1st July 2018 to 31st December 2019 in a tertiary cancer center. Aspirations from ovary and other pelvic masses-18 gauge, liver/gall bladder-22- 23 gauge and kidney-23 gauge spinal needles were taken respectively. Results: Total 161 cases of intra-abdominal lesions- ovary- 73 cases, liver-45 cases, kidney-27 cases, gall bladder-07 cases, colon (caecum+descending colon)-03 cases and pelvis mass- 03cases, pancreas- 02 cases and retroperitoneal lymph node-01 case were retrieved and studied. Ultrasound guided aspirates were conclusive for reporting in 145 cases, inconclusive for reporting in 10 cases and acellular/ haemorrhagic in 06 cases. There was high sensitivity and specificity of 90.9% and 100% respectively. Conclusion: Real time image guided FNAC is the method of choice for intra-abdominal masses with better cell yield and minimal complication. It permits precise localization and targeting of lesions safely. The localization is good in most of the masses but, it’s challenging in few locations. Complication like needle track seedling, discussed in many studies, was not seen in the present study. Keymessage: Image guided FNAC is very rewarding in diagnosis of intra-abdominal masses. USG guided FNAC is easy, causes minimal radiation, rapid reporting, less complication and needle tip can be easily visualized and manipulated in any direction, thus aids in faster planning if the treatment. Keywords: Real time Ultrasound guided FNAC, Intra-abdominal and intra-pelvic mass.

View Article

Abstract

Lung carcinoma is the most common and lethal malignancy in men. Non-small cell lung carcinoma is more aggressive than small cell lung carcinoma and often presents in advanced stage with metastasis. Cytology, histopathology, immunohistochemistry and metabolic imaging play an important role in classifying lung carcinomas. TTF 1 and Napsin A are highly sensitive and specific for adenocarcinoma lung, but the sensitivity and specificity decreases in high grade tumours. Elevated serum CA 19-9 tumour marker is not always related to pancreatico-biliary adenocarcinomas. It can be positive in adenocarcinoma lung and its elevation confers poor prognosis. Quintessential role of metabolic imaging like 18F-FDG PET CT scan in high grade carcinomas is well known. With the advent of targeted therapy, molecular and receptor studies of EGFR, ROS 1 and ALK gene rearrangement becomes mandatory in all lung adenocarcinomas. Hence, both oncologist and pathologist should diagnose advanced stage tumours without bias with good clinical, radiological and pathological correlation. Keywords: Lung adenocarcinoma, Immunohistochemistry, CA 19-9, TTF1, Napsin A, Metabolic imaging.

View Article