Efficacy of directed percutaneous fine-needle aspiration cytology in the diagnosis of intra-abdominal masses
C. Smith and J. A. Butler
Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509.
Directed percutaneous fine-needle aspiration (FNA) cytology was performed
on 113 patients with intra-abdominal masses. The 47 male and 56 female
patients had a median age of 56 years (range, 17 to 83 years). Computed
tomography (CT) was used to localize the needle in 90 cases, and
ultrasonography was used in the remaining 24 cases. The predominant sites
aspirated were the liver (n = 40), pancreas (n = 23), and pelvis (n = 14).
Seventy-eight of the 113 patients had a malignant neoplasm. Fine-needle
aspiration cytology correctly identified 63 (88%) of the 78 cases. There
were no false-positive studies. Computed tomography and UTZ ultrasonography
were equally sensitive in detecting malignant neoplasms. In 38 patients
with a history of previously treated malignant neoplasm, percutaneous
aspiration cytology confirmed the presence of recurrent disease in 24 (75%)
of 32 patients. Results of aspiration cytology obviated the need for a
diagnostic laparotomy in 51 (65%) of the 78 patients with a malignant
neoplasm. There was no serious morbidity or mortality associated with the
procedure. We conclude that CT/ultrasonography-directed percutaneous FNA
cytology is the procedure of choice in the workup of patients with
intra-abdominal masses. The specificity is 100% and sensitivity is 90%. It
is particularly useful in patients with extensive disease that would not be
palliated by operation.