Computed Tomography Guided Fine Needle Aspiration Cytology of Lung and Mediastinal Lesions

Introduction: Computed tomography guided fine needleaspiration cytology is a safe and well established technique forthe diagnosis of lung and mediastinal lesions. This study wascarried out in the department of pathology in the tertiary healthcare and teaching institute where radiology department is wellestablished. The aim was to study the cytomorphology of thespectrum of the lung and mediastinal lesions and to correlatethe cytological diagnosis with the radiological diagnosis.Material and methods: Computed tomography guided fineneedle aspiration cytology was done in 90 pateints after takingwritten consent of the patient. Patients were explained thebenefits and risks of the procedure. The results were analysed.Results: A total of 90 patients were included in the study.There were 81 patients of lung lesions and nine patients ofmediastinal lesions. There were 63(70%) males and 27(30%)females. Adequate aspirate was obtained in 77 patientsgiving the adequacy rate of 85.55%. Adenocarcinomawas the most common type of lung malignancy and NonHodgkins Lymphoma was the most common malignancyin the mediastinum. Inflammatory lesions were seen in 13cases. Granulomatous lesions were found in six patients. Oneinteresting case of hydatid with aspergillosis was diagnosedon cytology smears, which on radiology was diagnosed asneoplastic. Pneumothorax was seen in three patients. Nopatient required chest tube insertion.Conclusion: Computed tomography guided fine needleaspiration cytology is a safe and reliable method for thediagnosis of lung and mediastinal lesions. It can help inearly diagnosis and initiation of the treatment avoiding majorsurgical procedures.

An Unusual Cause of a Pulmonary Mass: Actinomycosis.

We present the case of a 62-year-old male with chronic obstructive pulmonary disease and poorly controlled diabetes mellitus who presented with haemoptysis. A radiograph of the chest showed a right lower parahilar opacity which on the contrast enhanced computed tomography was seen to be an irregular, spiculated mass localised to the middle lobe. Considering malignancy as the most probable diagnosis, a bronchoscopic endobronchial biopsy was performed which surprisingly established pulmonary actinomycosis as the diagnosis. The patient was successfully managed with amoxicillin and clavulanic acid and glycaemic control.

The value of 64-row helical CT multi-phase enhancement scan combined with angiography in the diagnosis of pulmonary mass / 重庆医学

Objective To explore the value of 64-row helical CT multi-phase enhancement scan combined with angiography (CTA)in the diagnosis of pulmonary mass.Methods Two hundred and sixty-five patients with pulmonary mass confirmed by pa-thology were checked,analyzed the CT sign of multi-phase enhancement scan and the blood supply of pulmonary mass displayed by CTA.Results Lung cancer was mainly supplied by bronchial arteries,some by body arteries,the feeding arteries display rate of lung cancer group was significantly higher than that of benign disease group(P 0.05).Enhancement dynamic curves of lung cancer group was differ-ent from benign lesion groups:Lung cancer without obvious enhancement in pulmonary artery phase,CT value increased rapidly in aorta phase,120 s reached peak,and declined slowly in delay phase;CT value of tuberculoma was increased slowly without obvious peak;CT value of inflammatory increased gradually in pulmonary artery phase,90 s reached the peak;hamartoma was no obvious enhancement;Hemangioma enhanced rapidly after strengthening in the pulmonary artery phase,reached the peak at about 15 s,and then decreased slowly.Conclusion 64-row helical CT multi-phase enhancement scan combined with angiography have important clinical value,which can differentiate malignant mass from benign ones.

A case of allergic bronchopulmonary aspergillosis shown as bilateral pulmonary masses / 결핵

The first case of allergic bronchopulmonary aspergillosis(ABPA) was reported by Hinson, et al. in 1952. This was followed by a number of significant description of the disorder. Although typical ABPA initially presents with asthma, fleeting pulmonary infiltrates, and marked eosinophilia, there are many other ways in which the disease may be first manifested. Common radiologic findings in ABPA include pulmonary infiltrates, atelectasis, emphysema, fibrosis, lobar shrinkage with hilar elevation, cavitation, pneumothorax, aspergilloma and central bronchiectasis. We experienced a case of allergic bronchopulmonary aspergillosis presenting rare radiologic finding of bilateral pulmonary masses in chest radiography. With oral corticosteroid treatment, the size of both pulmonary masses was decreased significantly and his asthmatic symptoms were improved.

Comparison between Transthoracic Fine Needle Aspiration Cytologyand Gun Biopsy of Pulmonary Mass / 대한세포병리학회지

To compare the diagnostic yields and complication rates of transthoracic fine needle aspiration cytology(FNAC) and gun biopsy in the diagnosis of pulmonary mass, a retrospective review was performed in 125 cases. Under the fluoroscopic guide, FNAC was performed by 20G Chiba needle in 91 cases, core biopsy was done by 18.5 G vaccum needle attached with automated biopsy gun in 74 cases and both procedures were done together in 37 cases. Overall sensitivity was 88.4% in FNAC and 87.5% in gun biopsy. For malignant pulmonary tumors, correct type correlation with final diagnosis was obtained in 33(76.7%) out of 43 cases by FNAC and 30(75.0%) out of 40 cases by gun biopsy. For benign pulmonary lesions, there were correct type correlation in 14(35.0%) out of 40 cases by FNAC and 14(53.8%) out of 26 cases by gun biopsy. The complication was pneumothorax and hemoptysis. Pneumothorax occured in 11.1% of FNAC, 10.9% of gun biopsy and 10.9% of both technique, among which chest tube drainages were necessary in one patient by gun biopsy and in three patients by both technique. Although no significant difference of diagnositc accuracy and complication rate was found between FNAC and gun biopsy, gun biopsy was more helpful in the diagnosis of pulmonary benign lesions than FNAC.