Abstract 6.  (1)8



Audit of Transthoracic Fine Needle Aspiration of the Lung: Cytological

Sub-classification of Bronchogenic Carcinomas and Inflammatory Conditions


Momani, J.1, F. Khamash2, & M. A. Taher2


1 Division of Pulmonology,

2 Divisions of Thoracic Surgery, King Hussein Medical Centre, Amman, Jordan


Abstract: Transthoracic fine-needle aspiration cytology (FNAC) is a useful tool for evaluating neoplastic and inflammatory lung nodules. In view of the relative paucity of published audit studies regionally, such a study was undertaken to assess the use of the technique in our centre. One hundred and fourteen FNACs were performed during 1993-1999. Immediate assessment for specimen adequacy was done. Diagnoses were correlated with clinical-pathological information and selective blind review performed. Cytologically, 65.8% of cases were malignant, 1.8% was atypical, 25.4% were inflammatory / nonmalignant and 7% were inadequate. Cytological histological tumor diagnostic concordance was 94.4%. Diagnostic sensitivity for malignancy was 93.4%, specificity: 95.8%, accuracy; 94%. Eight inadequate/benign cases (7%) proved to be malignant with clinical-pathological follow-up. Tuberculosis was confirmed (acid-fast bacilli detected) in six cases (5.3%) and suggested in a further 10 cases (8.8%). The cytological review showed 96% concordance with the original benign/malignant diagnoses. Pneumothorax rate was 18%. NAC is an accurate and safe method for the evaluation of lung nodules and it enables sub-classification of bronochogenic carcinomas in the vast majority of cases. It is also useful for the diagnosis of tuberculous pulmonary nodules. Immediate assessment optimizes specimen adequacy; inadequate/non-malignant smears in particular, need clinical correlation, close follow-up and re-biopsy, if necessary.

Key words: Transthoracic, FNAC, cytology.

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