Computed tomography (Ct) guided transthoracic needle aspiration cytology in difficult thoracic mass lesions-not approachable by USG

Objectives : To evaluate the diagnostic accuracy and complications of Computed tomography (CT) guided aspiration cytology in thoracic masses and to know the pathological spectrum of thoracic masses along with the correlation of CT findings with cytopathological reports. Material and Methods : 34 patients underwent CT-guided FNAC of thoracic lesions using a 20-gauge spinal needle. The diagnostic accuracy, sensitivity, specificity, positive and negative predictive values of the FNAC procedure were calculated. Results : Of these 34 patients 22 presented with pulmonary parenchymal lesions, 6 with mediastinal lesions and 3 each with hilar and pleural lesions. Conclusive cytodiagnosis was possible in 29 out of 34 patients (diagnostic accuracy 85.3%). Four cases (11.8%) developed pneumothorax and pulmonary hemorrhage, which did not require any treatment. The sensitivity and specificity for a diagnosis of malignancy was 92.6 & 100% respectively. Conclusion : CT-guided FNAC using a 20-gauge spinal needle is a highly sensitive and specific technique with a good diagnostic accuracy and can be used safely as an outdoor procedure in the diagnosis of thoracic masses that are not approachable by ultrasound.