Role of FNA in the initial management of a wide range of pathological conditions: 3-years experience in a teaching hospital. | ||
| Medical Journal of Tikrit | ||
| Article 1, Volume 1, Issue 181, December 2012, Pages 83-94 | ||
| Author | ||
| Nazar M.T. Jawhar | ||
| Abstract | ||
| OBJECTIVE: The aim of this study is to determine the utility and accuracy of fine needle aspiration (FNA) cytology in the diagnosis of a wide range of pathological conditions, to increase the awareness about this test to those who are unfamiliar with it and to compare the results with that of others. METHODS: All patients with palpable lesions and azospermia attending to the hospital during the period 2009 through to 2011 were included in this study. The patients were interrogated and a complete history and physical examination was conducted. The procedure is performed in an outpatient setting without any image guidance. The aspirated smears were stained and examined and the specimens were assigned to one of four different diagnoses: unsatisfactory/inadequate, negative for malignancy, atypical/suspicious, and positive for malignancy. The cases were followed up and if surgical excision done, the results were compared to that of FNA and the reliability and accuracy of FNA were evaluated for all cases. RESULTS: A total of 566 FNAs were performed 162 male and 404 female patients. There were 11 inadequate smears ( 1.94%) with an overall adequacy rate of 98.06%. Most of the insufficiency was seen in thyroid cases. Two hundred seventy three (273) FNAs were thyroid aspirate, 127 breast, 98 lymph node, and 24 had salivary gland enlargement. In addition there were five (5) patients had soft tissue lesions. Thirty nine (39) patients underwent testicular FNA for assessment of infertility. Only 273 (51.8%) had subsequent surgical biopsy. Comparison of FNA with subsequent biopsy results showed an accuracy rate of 95.23%. Overall false positive results were seen in only 5 cases (1.8%) most of which are thyroid cases, while false negative results were reported in only 8 cases (2.93%) and breast cases were the most common. The total sensitivity of FNA procedure was 89.47%% and specificity 97.46%, with the predictive value for positive diagnosis 93.15 % and for negative diagnosis 96%. CONCLUSION: FNA is a reliable safe and efficient tool that can yields a definitive diagnosis in a wide range of inflammatory, benign and malignant lesions. The results of this study are similar to those found in previous regional and international studies. Its use for routine diagnosis must be encouraged particularly in underdeveloped countries. | ||
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