Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2013; 02(01): 007-013
DOI: 10.4103/2278-330X.105872
Mini Symposium - FNAC VERSUS CORE BIOPSY: Original Article

Anterior mediastinal masses: A study of 50 cases by fine needle aspiration cytology and core needle biopsy as a diagnostic procedure

Jitendra G. Nasit
Department of Pathology, P. D. U. Government Medical College and Hospital, Rajkot, Gujarat
,
Maulin Patel
Crossworld Blood Bank and Sankalp Diagnostics, Ahmedabad, Gujarat
,
Biren Parikh
The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat
,
Manoj Shah
The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat
,
Kajal Davara
Department of Preventive and Social Medicine, M. P. Shah Medical College, Jamnagar, Gujarat
› Author Affiliations Source of Support: Nill.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Background: Mediastinal tumors are an uncommon abnormalities found in clinical practice. Anterior mediastinum is the common site and tissue diagnoses of anterior mediastinal masses (AMMs) are very important for correct therapeutic decision. Objective: We evaluate the different malignant AMMs in various age groups and the sensitivity of fine needle aspiration cytology (FNAC) and core needle biopsy (CNB). Cytology smears are reviewed with particular emphasis on pitfalls in the cytological diagnosis. Materials and Methods: This was a prospective study of 50 patients who were consulted for AMMs and underwent FNAC and CNB under guidance of ultrasound or computed tomography (CT) scan from 2006 to 2011. Cytology smears and histological sections were evaluated in all patients. Results: Among 50 cases, 36 were male and 14 were female. Most AMMs (52%) were identified in the fifth and sixth decades of life. Metastatic carcinoma and nonHodgkin′s lymphoma are the common AMMs. Adequate tissue material was obtained in 49 of 50 cases by CNB. Of these 49 patients, 35 (71.42%) cases were diagnosed correctly by FNAC, whereas 14 (28.57%) cases were not diagnosed definitely by FNAC. The sensitivity of CNB for AMMs was 97.95%, significantly higher than FNAC (71.42%) ( P < 0.05). CNB had statistically significant higher diagnostic rate than FNAC in the noncarcinoma group (100% versus 62.96%) ( P < 0.05). There is no significant difference of CNB and FNAC in carcinoma group ( P > 0.05). Diagnostic rate of FNAC was higher for carcinomatous lesions (81.81%) than for noncarcinomatous lesions (62.96%). Conclusion: Ultrasound or CT scan-guided CNB in combination with FNAC are safe, minimally invasive, and cost-effective procedure, which can provide a precise diagnosis in the AMMs, and may obviate the need for invasive surgical approach. FNAC usually suffice for carcinomatous lesions but CNB should be performed whenever the diagnosis of carcinoma is equivocal or noncarcinoma lesions are suspected.

Key words

Anterior mediastinal masses - core needle biopsy - fine needle aspiration cytology


Publication History

Article published online:
31 December 2020

© 2013. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Tscheikuna J, Suttinont P. Is cytology necessary in diagnosis of mediastinal mass? J Med Assoc Thai 2009;92:S24-9.
  • 2 Shrivastava CP, Devgarha S, Ahlawat V. Mediastinal tumors: A clinicopathological analysis. Asian Cardiovasc Thorac Ann 2006;14:102-4.
  • 3 Vaziri M, Pazooki M, Zahedi-Shoolami L. Mediastinal Masses: Review of 105 Cases. Acta Med Iran 2009;47:297-300.
  • 4 Desai F, Shah M, Patel S, Shukla SN. Fine needle aspiration cytology of anterior mediastinal masses. Indian J Pathol Microbiol 2008;51:88-90.
  • 5 Karki S, Chalise S. Analysis of mediastinal lesions: A study of 27 cases. Journal of Pathology of Nepal 2011;1:114-7.
  • 6 Safavi E, Hosseinian SM, Firoozbakhsh S. The value of percutaneous core needle biopsy in the diagnosis of anterior mediastinal tumors. Tanaffos 2004;3:7-11.
  • 7 Fang WT, Xu MY, Chen G, Chen Y, Chen WH. Minimally invasive approaches for histological diagnosis of anterior mediastinal masses. Chin Med J (Engl) 2007;120:675-9.
  • 8 Rendina EA, Venuta F, De Giacomo T, Ciccone AM, Moretti MS, Ibrahim M, et al. Biopsy of anterior mediastinal masses under local anesthesia. Ann Thorac Surg 2002;74:1720-2.
  • 9 Annessi V, Paci M, Ferrari G, Sgarbi G. Ultrasonically guided biopsy of anterior mediastinal masses. Interact Cardiovasc Thorac Surg 2003;2:319-21.
  • 10 Zinzani PL, Corneli G, Cancellieri A, Magagnoli M, Lacava N, Gherlinzoni F, et al. Core needle biopsy is effective in the initial diagnosis of mediastinal lymphoma. Haematologica 1999;84:600-3.
  • 11 Morrissey B, Adams H, Gibbs AR, Crane MD. Percutaneous needle biopsy of the mediastinum: Review of 94 procedures. Thorax1993;48:632-7.
  • 12 Samad SA, Sharifah NA, Zulfiqar MA, Maimunah A, Yahya A, Zainudin W. Ultrasound guided percutaneous biopsies of suspected mediastinal lesions. Med J Malaysia 1993;48:421-6.
  • 13 Adler OB, Rosenberger A, Peleg H. Fine-needle aspiration biopsy of mediastinal masses: Evaluation of 136 experiences. AJR Am J Roentgenol 1983;140:893-6.
  • 14 Jereb M, Us-Krasovec M. Transthoracic needle biopsy of mediastinal and hilar lesions. Cancer 1977;40:1354-7.
  • 15 Weisbrod GL. Percutaneous fine-needle aspiration biopsy of the mediastinum. Clin Chest Med 1987;8:27-41.
  • 16 Hsu WH, Chiang CD, Hsu JY, Kwan PC, Chen CL, Chen CY. Ultrasonically guided needle biopsy of anterior mediastinal masses: Comparison of carcinomatous and non-carcinomatous masses. J Clin Ultrasound 1995;23:349-56.
  • 17 Zafar N, Moinuddin S. Mediastinal needle biopsy. A 15-year experience with 139 cases. Cancer 1995;76:1065-8.
  • 18 Wernecke K, Vassallo P, Peters PE, von Bassewitz DB. Mediastinal tumors: Biopsy under US guidance. Radiology 1989;172:473-6.
  • 19 Weisbrod GL, Lyons DJ, Tao LC, Chamberlain DW. Percutaneous fine-needle aspiration biopsy of mediastinal lesions. AJR Am J Roentgenol 1984;143:525-9.
  • 20 Böcking A, Klose KC, Kyll HJ, Hauptmann S. Cytologic versus histologic evaluation of needle biopsy of the lung, hilum and mediastinum. Sensitivity, specificity and typing accuracy. Acta Cytol 1995;39:463-71.
  • 21 Sawhney S, Jain R, Berry M. Tru-Cut biopsy of mediastinal masses guided by real-time sonography. Clin Radiol 1991;44:16-9.
  • 22 Yu CJ, Yang PC, Chang DB, Wu HD, Lee LN, Lee YC, et al. Evaluation of ultrasonically guided biopsies of mediastinal masses. Chest 1999;100:399-405.
  • 23 Hsu WH, Chiang CD, Hsu JY, Chen CY, Chiang CS, Lee T. Value of ultrasonically guided needle biopsy of pleural masses: An under-utilized technique. J Clin Ultrasound 1997;25:119-25.
  • 24 Yang PC, Lee YC, Yu CJ, Chang DB, Wu HD, Lee LN, et al. Ultrasonographically guided biopsy of thoracic tumors. A comparison of large-bore cutting biopsy with fine-needle aspiration. Cancer 1992;69:2553-60.
  • 25 Singh HK, Silverman JF, Powers CN, Geisinger KR, Frable WJ. Diagnostic pitfalls in fine-needle aspiration biopsy of the mediastinum. Diagn Cytopathol 1997;17:121-6.
  • 26 Geisinger KR. Differential diagnostic considerations and potential pitfalls in fine-needle aspiration biopsies of the mediastinum. Diagn Cytopathol 1995;13:436-42.