Blind Transthoracic Fine Needle Aspiration Cytology as a Diagnostic Tool in Suspected Lung Cancer in Resource Poor North-Eastern Part of India

Unguided FNAC may be the only option left for accurate diagnosis of malignant lesions in the lung in resource poor settings. The present study was done with the aim of assessing the accuracy and utility of unguided transthoracic fine needle aspiration cytology in the diagnosis of lung cancer. Methods: An interventional study was taken up in the Department of Respiratory Medicine, JN Institute of Medical Sciences, Imphal. All patients admitted in the IPD with suspected malignant lung lesions during the period July 2017-Dec 2018 was included. After obtaining prior informed written consent fine needle aspiration was done from the dullest area on chest wall by using a lumbar puncture needle under local anaesthesia. The slides prepared thereafter were alcohol-fixed and sent to the Department of Pathology, JNIMS for cytological examination. The patients were observed closely after the intervention to detect any complications. Results: Completed data sets could be obtained from 20 study subjects. Unguided fine needle aspiration cytology had a diagnostic yield of 75% for detecting malignant lesions in the lung. Only minor post-procedure complications were encountered in 10% of the patients. Conclusion: The unguided trans-thoracic fine needle aspiration cytology has many merits. It is rapid, safe, accurate and cost-effective for the diagnosis of intra-thoracic peripheral lesions. It can also be used as an outdoor procedure even in peripheral health centres in properly selected cases.