THE ROLE OF INTRAOPERATIVE FINE NEEDLE ASPIRATION BIOPSY: A PROSPECTIVE ANALYSIS

Abstract

Fine needle aspiration biopsy (FNAB) has become increasingly popular as a diagnostic technique, asit provides a sensitive and useful method of obtaining cytologic material for examination. It's also a rapid and economical method to use intraoperatively. In order to evaluate the efficacy of the technique in this manner, prospectively, we performed FNAB s in 58 lesions in 43 patients aged 22 to 73 years, FNAB was carried out in the standard fashion by using 17 or 20-gauge needle fitted to a 20 mL syringe andMay-Grunwald-Giemsa staining. The locations and the number of the lesions were as follows: intraabdominal lymph nodes (13), liver (9), colon (8), stomach (8), rectum (4), thyroid (5), breast (3),pancreas (2), small bowel (2), esophagus (1), adrenal (1),spleen (1),and gall bladder (1), However, in three lesions the aspirate was inadequate for cytologic examination. Forty-two lesions were malignant, though three of these were not available f or excision to be confirmed by histopathological examination. Only one false positive result belonged to a pheochromocytoma case which was reported as adenocarcinoma with FNAC. In search of metastasis in the lymph nodes of different patients, 3 false negative results were obtained. Overall results for intraoperative FNAC were: sensitivity, 93.2 %; specificity, 91%; positive predictive value, 97.6%; and negative predictive value, 77%. We concluded that intraoperative FNAC is a complementary method of choice providing the surgeon to perform rapid and safer serial biopsies for avoidance of the risks of open biopsy.