Role of FNAC in the diagnosis of ovarian tumours

Abstract

Author(s): Aswathi Krishnan M*, Sheeja S and Lillykutty Pothen

Fine Needle Aspiration Cytology (FNAC) is a cost effective, minimally invasive technique which is used for diagnosing various non-neoplastic and neoplastic lesions. However, its use is restricted in ovarian cancer diagnosis due to various factors such as difficulty in sub-typing with cytology alone, fear of spillage of tumor cells to peritoneal cavity etc. In this study, we analysed 45 cases of ovarian masses and FNAC of these cases were performed Under Ultrasonography (USG) guidance. Histopathology diagnosis was compared with cytology in all these cases. For statistical analysis, 39 cases were considered. Cytological analysis detected 18 cases as malignant neoplasms and all of them were found to be malignant in histological analysis as well. In the present study, no incidence of cyst rupture or any other complication occurred during the procedure. FNAC is a safe and economic procedure with acceptable diagnostic accuracy especially in the experienced hands. False negative results of FNAC in ovarian cystic lesions were mainly due to the low cellularity of the sample and secondary degenerative changes. This can be avoided to certain extend by preparing cell blocks and hence we suggest the same. The distinction between cystadenocarcinoma and borderline tumours cannot be confidently made by cytology alone. All clinical and sonographic findings should be considered in collaboration with FNAC findings for arriving at a diagnosis.

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