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Role of Cell Block in Guided FNAC of Abdominal Masses

机译:细胞块在腹部肿块引导性FNAC中的作用

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Introduction: Fine Needle Aspiration (FNA) of space occupying lesions in superficial or deep anatomic sites is an increasingly common procedure, providing rapid and safe diagnosis. However, sometimes FNA does not yield sufficient information for a precise diagnosis and the risk of false negatives and indeterminate diagnosis is always present. Therefore, we attempted to obtain additional information via the preparation of Cell Block (CB) from the residual material of aspirates and thus enhance the diagnostic accuracy. Aim: This study was carried out to evaluate the role of CB as a useful adjunct to smears for establishing a more definitive cytopathologic diagnosis and for its utility in special staining and Immuno-histochemistry (IHC). Materials and Methods: A total of 66 cases of image-guided FNA of abdominal masses were studied. In addition to the routine smears, CBs were prepared from the residual tissues for all possible cases and its diagnostic efficacy was analysed. Further, the use of CBs for special staining and IHC was also established. R esults: This study included a total of 66 patients with abdominal masses who were referred for guided FNA cytology. Out of these cases, adequate material was obtained on FNAC in 64 cases (96.96%) and on CB in 45 cases (68.18%) and the diagnosis was provided. There was a good agreement between the FNA smear diagnosis and CB diagnosis. The histopathology of CB sections further helped in precise final cytopathological diagnosis. Two FNA smears were unsatisfactory for evaluation and hence the diagnosis was done on CB sections alone. With FNA cytology and CB in combination, a cytopathological diagnosis was given for all the 66 cases. The sensitivity of FNA in comparison to the histopathology of CB was 91.6% and specificity was 88.8%. The diagnostic accuracy was 62% and the discordance was 6%. Conclusions: CB in addition to the routine FNA is a simple, reliable and cost-effective technique that further contributes to the final cytopathological diagnosis.
机译:简介:浅表或深部解剖部位占位性病变的细针穿刺术(FNA)是一种越来越普遍的方法,可提供快速,安全的诊断。但是,有时FNA无法提供足够的信息来进行精确诊断,并且始终存在假阴性和不确定诊断的风险。因此,我们试图通过从吸出物的残留物中制备细胞块(CB)获得更多信息,从而提高诊断准确性。目的:进行这项研究以评估CB作为涂片的有用辅助物的作用,以建立更明确的细胞病理学诊断及其在特殊染色和免疫组织化学(IHC)中的效用。材料与方法:共研究66例腹部肿块影像引导下FNA的病例。除了常规涂片检查外,还针对所有可能的情况从残留组织中制备了CB,并对其诊断功效进行了分析。此外,还建立了将CB用于特殊染色和IHC的用途。结果:本研究共纳入66例腹部肿块患者,他们接受了引导性FNA细胞学检查。在这些病例中,有64例(96.96%)的FNAC和45例(68.18%)的CB获得了足够的材料,并提供了诊断。 FNA涂片诊断与CB诊断之间达成了良好的共识。 CB切片的组织病理学进一步有助于精确的最终细胞病理学诊断。两次FNA涂片检查均不能令人满意,因此仅对CB切片进行诊断。结合FNA细胞学检查和CB检查,对所有66例病例进行了细胞病理学诊断。与CB的组织病理学相比,FNA的敏感性为91.6%,特异性为88.8%。诊断准确性为62%,不一致率为6%。结论:除了常规FNA之外,CB是一种简单,可靠且具有成本效益的技术,进一步有助于最终的细胞病理学诊断。

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