J Pathol Transl Med.  2015 Mar;49(2):129-135. 10.4132/jptm.2015.01.28.

Image-Guided Fine Needle Cytology with Aspiration Versus Non-Aspiration in Retroperitoneal Masses: Is Aspiration Necessary?

• Misra RK
• Mitra S
• Jain RK
• Vahikar S
• Bundela A
• Misra P

• KMID: 2381367
• DOI: http://doi.org/10.4132/jptm.2015.01.28

Abstract

BACKGROUND
Although using fine needle cytology with aspiration (FNC-A) for establishing diagnoses in the retroperitoneal region has shown promise, there is scant literature supporting a role of non-aspiration cytology (FNC-NA) for this region. We assessed the accuracy and reliability of FNC-A and FNC-NA as tools for preoperative diagnosis of retroperitoneal masses and compared the results of both techniques with each other and with histopathology.
METHODS
Fifty-seven patients with retroperitoneal masses were subjected to FNC-A and FNC-NA. Smears were stained with May-Grunwald Giemsa and hematoxylin and eosin stain. An individual slide was objectively analysed using a point scoring system to enable comparison between FNC-A and FNC-NA.
RESULTS
By FNC-A, 91.7% accuracy was obtained in cases of retroperitoneal lymph node lesions followed by renal masses (83.3%). The diagnostic accuracy of other sites by FNC-A varied from 75.0%-81.9%. By FNC-NA, 93.4% diagnostically accurate results were obtained in the kidney, followed by 75.0% in adrenal masses. The diagnostic accuracy of other sites by FNC-NA varied from 66.7%-72.8%.
CONCLUSIONS
Although both techniques have their own advantages and disadvantages, FNC-NA may be a more efficient adjuvant method of sampling in retroperitoneal lesions.

Keyword

Fine needle aspiration; Non-aspiration technique; Retroperitoneal masses

MeSH Terms

Biopsy, Fine-Needle
Diagnosis
Eosine Yellowish-(YS)
Hematoxylin
Humans
Kidney
Lymph Nodes
Needles*
Eosine Yellowish-(YS)
Hematoxylin

Figure

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  Fig. 1. (A) Fine needle aspiration cytology of neuroblastoma showing sheets and clusters of round, monomorphic tumor cells on a hemorrhagic background. (B) Non-aspiration cytology of neuroblastoma showing clusters and dispersed small, round cells with a high nucleocytoplasmic ratio and scant cytoplasm.

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  Fig. 2. (A) Fine needle cytology with non-aspiration smear of renal cell carcinoma showing sheets and clusters of cells with abundant, delicate, wispy, finely vacuolated cytoplasm and enlarged nuclei, fine chromatin, prominent nucleoli and thick irregular nuclear border on a relatively clean background. (B) Fine needle cytology with aspiration smear of renal cell carcinoma showing a sheet of cells with abundant vacuolated cytoplasm (arrow) and enlarged nuclei on a haemorrhagic background.

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