Ultrasound guidance for biopsy of omental abnormalities (original) (raw)
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Observations on the ultrasound diagnosis of ovarian neoplasms
Archives of Gynecology and Obstetrics, 1987
In order to determine whether sonography could differentiate between benign and malignant ovarian neoplasms a retrospective analysis of preoperative ultrasound examination was made. The ultrasound images were evaluated for internal consistency, presence of septae, presence of solid nodules, papillary projections and tumor borders. Evidence of ascites and omental involvement were also assessed. Our study showed that benign ovarian serous tumors had a similar appearance to low grade malignant serous tumors, and were undistinguishable from the borderline serous carcinoma. The poorly differentiated serous adenocarcinoma was characterized by the presence of thick papillary projections rather than echogenicity. However, benign or malignant mucinous tumors gave the same pattern. Loss of tumor wall definition, ascites and omental involvement may signal malignancy. The dermoid tumor had a characteristic sonographic appearance.
Fine needle aspiration cytology of ovarian tumors with histological correlation
Journal of Cytology, 2012
Background: Till today, there has been some hesitation to accept the role of fine needle aspiration cytology (FNAC) in pelvic mass. We have tried to study the role of ultrasonography (USG) and computed tomography (CT) guided FNAC as diagnostic and supportive investigation for ovarian tumors. Aim: To evaluate the current status of image-directed percutaneous aspiration of ovarian neoplasm for the purpose of early detection of malignancy. Materials and Methods: Seventy-four fine needle aspirations of ovarian neoplasms were performed between January 2007 and December 2008 by transabdominal approach under USG and CT guidance and correlated with histopathological findings and tumor markers. Results: A total of 47 (63.5%) cases were assessed as malignant and 21 (28.3%) as benign and 6 (8.1%) as inconclusive. The neoplastic lesions were categorized as per World Health Organization (WHO) classification. Conclusion: With the availability of modern techniques, USG and CT guided FNAC can be an optimum modality for the diagnosis of primary and metastatic ovarian neoplasms and evaluation of recurrent malignant tumors, which has great impact on patient management consequently.
Ultrasound and color power Doppler in the detection of metastatic omentum: a prospective study
Ultrasound in Obstetrics and Gynecology, 2005
Objectives To analyze prospectively the ability of ultrasound to detect metastatic omentum in patients with suspicious pelvic masses and to describe the sonographic features of metastatic omental disease. Methods One hundred and eighty-four patients were evaluated preoperatively by ultrasound examination and of these 173 were used in the analysis. We defined as an ultrasound-positive examination one which visualized intra-abdominal aperistaltic solid tissue, located above the bowel loops and below the anterior peritoneal surface. Preoperative sonographic findings were compared with pathological results. Results Sonographic detection of metastatic omentum was achieved in 104 of 173 patients (60.1%), appearing as either solid aperistaltic tissue (80.8% of cases), or as solid discrete nodules (19.2%). When considering the echostructure of the surrounding bowel loops, this tissue appeared hypoechoic in 46 (44.2%) cases and isoechoic or slightly hyperechoic in the other 58 (55.8%) cases. In the overall series, the negative and positive predictive values (NPV and PPV) and the accuracy of ultrasound examination were 92.7%, 91.3% and 91.9%, respectively. When considering only the group of ovarian tumors, the NPV, PPV and accuracy were 91.9%, 94.6%, and 93.8%, respectively. Conclusion Ultrasound examination is highly accurate in detecting metastatic omental involvement in cases with suspicious pelvic masses.
2021
Background: The objective of our study was to determine the diagnostic value and safety of ultrasound guided percutaneous biopsy of omental thickening. Methods: We prospectively analyzed 60 patients who underwent USG-guided omental biopsies in our institute from January 2016 to December 2016. Results: Total 60 patients were included in our study. There were 40 (66.7%) female and 20 (33.3%) male patients. There were total 36 (60%) malignant cases, 20 (33.3%) chronic inflammation suggestive of TB while 4 (6.7%) were chronic peritoneal infection. Out of 36 malignant cases, majority 24 (66.7%) had ovarian cancer, 8 (22.2%) had endometrium cancer and 4 (11.1%) had large bowel cancer. Repeat biopsies were performed only in 4 (6.7%) cases. Conclusions: Ultrasound-guided percutaneous biopsy of omentum is less expensive, safe and effective method with a high diagnostic accuracy.
Fine Needle Aspiration Cytology of Ovarian Tumours
Journal of Evidence Based Medicine and Healthcare, 2018
BACKGROUND Recent trends towards delayed child bearing have bolstered efforts to preserve ovarian tissue throughout the reproductive years. This trend combined with improvements in technology of high frequency sonography and increasing experience in cytopathological interpretation of ovarian cyst fluid has led to broader acceptance and utilization of ovarian FNAC. MATERIALS AND METHODS The study was undertaken on 47 patients from February 2003 to March 2005. FNAC of ovarian lesions by using 23 Gauge needle and Cameco syringe pistol with disposable 10 cc syringe and whenever required use of USG or CT guidance. The technique of aspiration and preparation of the slides closely followed those recommended by Franzen and Zajicek et al. RESULTS The study included 47 cases of which 55.32% were benign and 44.68% were malignant. The commonest benign tumour was simple ovarian cyst (13cases) and the commonest malignant tumour was mucinous cyst adenocarcinoma (09 cases). 13 (27.65%) cases were simple cysts which formed the major portion of this study.09 (19.14%) cases were diagnosed as mucinous cystadenocarcinoma. 08 (17.02%) cases were diagnosed as serous cystadenocarcinoma. Serous cyst adenocarcinomas in 02 cases were bilateral. Recurrence was diagnosed in 02 cases of known mucinous cystadenocarcinomas and 01 case of serous cystadenocarcinoma. CONCLUSION So, with the knowledge of limitations of FNAC, judicial use of this procedure along with detailed clinical history, use of USG/CT guidance and a skilful procedure as well as interpretation of smears, this method proves to be very effective and rewarding.
Tumori Journal, 1994
Aims and background The prognosis for ovarian cancer patients depends on the stage at diagnosis. As a prerequisite for any proposed procedure for ovarian cancer screening, high levels of specificity should be obtained using combinations of tests. Based on preliminary data from an ongoing feasibility study, this report is focused on the possible gain in specificity provided by fine-needle aspiration of occult ovarian masses detected by ultrasound. Methods Ultrasonography was used as a basic test, and fine-needle aspiration was obtained from selected patients. Those with (a) positive aspiration cytology or histology, (b) complex or solid masses showing volume increase, (c) complex or irregular masses and inadequate samples, and (d) recurrent cystic lesions were operated on. Results A total of 3541 asymptomatic patients 50-69 years of age underwent ultrasonography, and 98 were selected for fine-needle aspiration. Of these, 19 (positivity rate 19/3541 or 0.5%) were operated on. Two ovar...
Image guided biopsy in the management of cancer of the ovary
Cancer Imaging, 2006
When used in the context of multidisciplinary team discussion, image guided biopsy using ultrasound (US) or computed tomography (CT) guidance is of value in planning management of women with suspected ovarian cancer and peritoneal carcinomatosis (PC) of uncertain aetiology. It is essential in women believed to have ovarian cancer but with poor performance status or with advanced disease believed beyond the scope of primary cytoreductive surgery for whom staging surgical pathology will not be obtained. It provides a site-specific primary tumour diagnosis in 93% of cases and it should replace diagnostic laparoscopy or laparotomy for this purpose. It allows provision of primary (neoadjuvant) chemotherapy based on a firm histological diagnosis. It is mandatory in women with a history of cancer whose metastases may mimic ovarian cancer (e.g. breast, GI tract, melanoma). More women with prior breast cancer who re-present with peritoneal cancer will have a new gynaecological primary than recurrence of their original primary tumour; the two options require radically different therapies. Finally it is a valuable problem solving tool in situations of diagnostic uncertainty, e.g. unusual imaging patterns of disease such as PC with bilateral solid ovarian masses or non-enlarged ovaries and with an unusual tumour marker profiles suggesting primary tumours outwith the ovary. The technique is simple, safe and effective and can be combined with palliative drainage of ascites at the same procedure.
Pakistan Journal of Medical and Health Sciences, 2022
Objective: To depict and characterize CT patterns of omental pathology and to determine the validity of omental caking in diagnosis of ovarian cancer. Methodology: A cross-sectional study was conducted in a tertiary care center between January 2020 to February 2021. In this study, 64 consecutive female patients with omental pathology, scheduled for biopsy, surgery and follow up were included. All CT scans were reviewed and findings were discussed with the consultant radiologists. The results were compared and confirmed on histopathology by either open surgical biopsy or per-cutaneous needle biopsy. Result: A total of 64 patients were enrolled in the study. Omental caking on computed tomography was identified in 44 (68.8%) patients. Presence of Omental caking was significantly associated with ovarian cancer (p<0.001). The positive and negative predictive values were 86.4% and 75%, respectively. The sensitivity and specificity of omental caking as diagnostic criteria for ovarian ca...
Gynecologic Oncology, 1989
Ultrasound is now frequently used for evaluation of pathological findings discovered on gynecological examination and for puncture of ovarian cysts. Although the new, high-frequency vaginal transducers have a very high resolution, only macroscopitally visible structures of the tumors can be imaged. For this reason, it seemed important to classify ovarian tumors according to their macroscopic appearance and then relate this to whether the tumor was benign, borderline, or malignant. Such a classification has not been performed before. Medical records from women operated upon due to pelvic tumors over a period of 11 years were scrutinized. There were 1017 women included in the study. Among those tumors characterized as unilocular cysts 0.3% (l/296) was malignant; this tumor had macroscopically visible papillary vegetations on the inside of the cyst wall. This cyst was found in a woman 60 years old. Sixty percent (178/296) of the women who had a unilocular cyst were over the age of 40. Two percent (4/203) of the unilocular solid tumors were classified as malignant. The malignancy rates for multilocular cysts was 8% (20/229), multilocular solid tumors 36% (147/209), and solid tumors 39% (31/80). Papillary vegetation on the cyst wall was the structure that was most frequent in malignant tumors. Neither the thickness of the cyst wall nor the thickness of septa inside the tumor seemed to correlate with malignancy. Among the simple ovarian cysts, 65 had a diameter over 10 cm but none of them was malignant. The one that was malignant had a diameter of approximately 5 cm. In conclusion, unilocular ovarian cyst seems to carry a very slight chance of malignancy even in women over the age of 40. Papillary vegetation on the cyst wall, a structure that can be seen by ultrasound, seems to be a serious sign. #C 1989 Academic Press, Inc.