Ultrasound-guided fine-needle aspiration cytology diagnosis of gallbladder lesions: A study of 82 cases (original) (raw)
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Ultrasound-Guided Fine Needle Aspiration Cytology of Malignant Gallbladder Masses
Acta Cytologica, 1997
Background: The appropriate clinical management of various hepatic lesions depends on accurate diagnosis. Fine needle aspiration and cell block have gained popularity because they are convenient, minimally invasive, quick and have good performance profiles. Objective: To investigate the cytomorphological features of distinctive non-neoplastic and neoplastic lesions of the liver and to evaluate the sensitivity, specificity and diagnostic accuracy of ultrasound-guided (USG) fine needle aspiration cytology (FNAC) and cell block in the diagnosis of liver diseases at Khartoum Teaching Hospital. Method: A cross-sectional study was conducted at Khartoum Teaching Hospital, Sudan during the period of November 2008 to October 2011. One hundred and five cytological materials were collected from patients with focal liver lesions who referred after initial clinical and radiological assessment for ultrasound!guided fine needle aspiration cytology (USG-FNAC). Results: The age of the patients ranged from 5-60 years and 64 (61%) of these patients were males. Out of 105 investigated samples 76 (72.4%) and 41(39.0%) were malignant by cytology and cell block respectively. Out of these 105 samples, 71 were investigated by both cytology and cell blocks and were included in the final analyses of the FNAC in comparison to cell block. The sensitivity, specificity, positive predictive value and negative predictive value of the cytology were 100% (93.0 ! 100%), 63.3% (45.2 ! 79.0%), 78.8% (66.2 ! 88.3%) and 0 (0 ! 14.6%), respectively. Conclusion: Thus, USG-FNAC is a sensitive but not specific method in differentiating the benign and malignant focal liver lesions. Differentiation between primary liver malignant lesions and metastatic lesion needs adjunct techniques
IOSR Journals , 2019
Background and objectives: Gallbladder (GB) carcinoma is prevalent in the Gangetic plains of the Eastern Uttar Pradesh and Western Bihar regions of India. The present study was done to assess the utility of ultrasound (US) guided fine needle aspiration (FNA) in diagnosing GB carcinoma. Materials and Methods: A study was conducted over a period of one year from August 2017 to July 2018 in the Department of Pathology and Department of Radiodiagnosis in Indira Gandhi Institute of Medical Sciences, Patna. US guided fine needle aspiration was carried out, and aspirates were drawn, processed and evaluated. Results: Out of 117 aspirations, 93 (79.4%) were adequate, 15 (12.8%) were inconclusive, and 9 (7.6%) were inadequate. The most common carcinoma was adenocarcinoma in 75cases (64.1%). The overall diagnostic adequacy was 92.4%. The common causes of inconclusive cases were necrotic areas, aspiration of reactive hepatocytes adjacent to the GB mass, scant epithelial cells, inflammatory cells and mucus flakes. Histopathology of the GB was available in 24 cases. Conclusion: US guided FNA of gall bladder lesions is a simple, safe, economically prudent technique leading to quick and early diagnosis.
Digestive Diseases and Sciences, 2014
Background No previous studies have compared cytology obtained under endoscopic transpapillary gallbladder drainage (ETGD) and EUS-guided fine needle aspiration (EUS-FNA) for thick-walled gallbladders. Aim The present study investigated the diagnostic yield of bile cytology under ETGD and EUS-FNA for gallbladder tumors. Methods A total of 69 patients were diagnosed as having gallbladder wall thickening. Among these patients, 28 patients were diagnosed by clinical follow-up, solely by imaging such as computed tomography or by histological examination of surgical specimens. The remaining 41 patients underwent ETGD and/or EUS-FNA. In these 41 patients, the clinical data collected included gender, age, diameter of gallbladder wall, site of gallbladder wall thickening, final diagnosis, adverse events, and diagnostic yield of ETGD and EUS-FNA. Results Cyto-histological diagnosis with EUS-FNA was higher than that with ETGD, with a sensitivity of 100 versus 71 %, specificity of 100 versus 94 %, and accuracy of 100 versus 88 %, respectively, in the two groups. In addition, the sampling adequacy of EUS-FNA was 100 %. Adverse events were seen in five patients in the ETGD group (mild pancreatitis), although no adverse events were seen in the EUS-FNA group (P = 0.08). Conclusion Our results suggest that EUS-FNA can be safely performed for the diagnosis of gallbladder lesions. Further, this procedure may be the diagnostic method of choice over cytology of bile juice obtained via ETGD to obtain histological evidence of gallbladder cancer.
Cytologic diagnosis of gallbladder lesions - A study of 150 cases
The Indian journal of surgery, 2010
Gallbladder (GB) carcinoma is among the five most common forms of gastrointestinal cancers and the diagnosis is usually made when the carcinoma is already in an advanced stage. The aim of this study was to assess the application of ultrasound (US) guided fine needle aspiration (FNA) in diagnosing GB carcinoma. The present study was carried out on 150 patients suspected to have GB carcinoma on ultrasonography. US-guided FNA from GB was done in these patients and FNA of the other organs was simultaneously done in 20 patients. Histopathology of the GB was available in 14 cases. Ultrasonography in these patients revealed mass/thickening of the wall of GB in 140 (93.3%) cases and nonspecific US findings in 10 (6.7%). Out of the 140 cases malignancy was cytologically diagnosed in 105 (75%) cases while 12 (8.5%) cases were inflammatory and 23 (16.5%) were inconclusive. Adenocarcinoma was the most common morphologic type. Metastatic tumor deposits were noted in FNA from space occupying lesi...
Endoscopic ultrasound-guided FNA biopsy of bile duct and gallbladder: analysis of 53 cases
Cytopathology, 2006
Endoscopic ultrasound-guided FNA biopsy of bile duct and gallbladder: analysis of 53 cases Objective: Endoscopic retrograde cholangiopancreaticography (ERCP)-guided brushing has been the standard of practice for surveillance and detection of carcinoma in the biliary tree. Few studies have evaluated the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in diagnosing clinically suspected cholangiocarcinoma. The role of this method in diagnosing clinically suspected gallbladder malignancies has not been extensively evaluated in the USA. This study investigates the role of EUS-FNA in the diagnosis of clinically suspected biliary tree and gallbladder malignancies in a large patient series. Methods: EUS-FNAs were obtained from 46 bile duct and seven gallbladder lesions. On-site rapid interpretation was provided using air-dried Diff Quik stained smears. In addition, alcohol fixed Papanicoloau stained smears and Thin Prep preparations (Cytye Corp., Marlborough, MA, USA) were evaluated before providing a final cytological diagnosis. Tissue biopsies and/or clinical follow-up were used as the standards to determine operating characteristics for EUS-FNA. Results: The mean ages for bile duct and gallbladder lesions were 66 years (range: 37-84 years), and 69 years (range 49-86 years), respectively. All cases diagnosed as suspicious/malignant on preliminary evaluation were confirmed on final cytological interpretation (27/27). The operating characteristics show that EUS-FNA is highly specific (100%) with sensitivity rates of 87% and 80% from clinically suspected malignancies of biliary tract and gallbladder, respectively. Sampling error in three cases and associated acute inflammation in two cases resulted in false-negative diagnoses. Conclusions: EUS-FNA of biliary tree and gallbladder carcinoma is highly specific and should be considered for evaluation of clinically suspicious lesions. Marked inflammation may result in false-negative diagnoses.
Gallbladder Lesions Identified on Ultrasound. Lessons from the Last 10 Years
Journal of Gastrointestinal Surgery, 2012
Background Possible mass lesions identified on ultrasound (US) of the gallbladder may prompt an aggressive surgical intervention due to the possibility of a malignant neoplasm. Aim This study aims to utilize a large modern series of patients with gallbladder lesions identified on US to evaluate imaging characteristics consistent with malignancy. Methods A retrospective review was conducted of gallbladder ultrasound reports and clinicopathologic data of patients with a mass identified on US. Results Approximately 59,271 abdominal ultrasounds and 9,117 cholecystectomies were performed between February 2000 and February 2010. We identified 213 patients with a questionable gallbladder neoplasm on ultrasonography who underwent surgical exploration. Median age was 52 years (range=11-87 years) and 147 (69%) were females. Final pathology demonstrated no neoplasm in 130 patients (61%), while 32 patients (15%) had a wall adenomyoma, 36 (17%) had a polyp (five of which were malignant), 14 (7%) had an adenocarcinoma not arising from a polyp, and one patient had a cystic papillary neoplasm. The smaller the lesion, the more likely it was to be a pseudo-mass. For lesions measuring <5 mm on US, 83% had no lesion found on final pathology. Significant predictors of malignancy were age >52 years (p<0.001), presence of gallstones on US (p=0.004), size >9 mm (p<0.001), evidence of invasion at the liver interface (p<0.001), and wall thickening >5 mm (p<0.001). Shape (sessile or penduculated), echogenicity (echogenic or isoechoic), or presence of flow on Doppler were not predictors of malignancy. An US size of ≤9 mm had a negative predictive value of 100% for malignancy. Conclusions Despite improvements in imaging, most apparent lesions measuring <5 mm on US are not identified in the surgical specimen. US size >9 mm, age >52 years, US suggestion of invasion at the liver interface, and wall thickening >5 mm, especially in the presence of gallstones, should raise the suspicion of malignancy.
Endoscopy International Open, 2019
Background and study aims Although endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) is an established modality for pathological sampling of pancreatic and biliary lesions, limited data are available on the diagnostic value of EUS-FNA for evaluation of gallbladder mass lesions, a common cause of obstructive jaundice. We aimed to evaluate the usefulness of EUS-FNA for diagnosis of gallbladder mass lesions presenting with biliary obstruction. Patients and methods This study was a retrospective analysis of data from patients who had undergone EUS-FNA for gallbladder mass lesions. FNA was performed on either a gallbladder mass, metastatic node or liver lesions. Outcome measures were diagnostic yield of EUS FNA and adverse events. Results From April 2011 to August 2018, 101 patients with gallbladder mass lesions with biliary obstruction underwent EUS-FNA. The final diagnosis was malignancy in 98, benign disease in one, and two patients were lost to follow-up. EUS-FNA co...