Iftikhar Ahmad, Muhammad Nawaz Anjum, Najumuddin, Muhammad Yousaf Chaudhary, Noman Muddassir.
Diagnostic yield and complications of CT - Guided Fine Needle Aspiration in Mediastinal Masses
J Rawal Med Coll Jun 2003;7(1):8-11.
Department of Radiology, Holy Family Hospital, Rawalpindi

Background: To assess the diagnostic yield and safety of CT-guided fine needle aspiration (FNA) in mediastinal masses. Methods: This prospective multi-centre study was conducted from April 1997 to December 2002. It comprised of 45 patients, 26 male and 19 female, diagnosed with mediastinal mass. CT chest with contrast was performed in supine and prone positions, depending upon the best approach to the mass lesion in each case. For FNA, lesions were localized in expiration with contiguous scan of 5mm thickness. A 22-gauge needle was employed. Direct mediastinal approach was used. One to three passes were made to collect adequate specimens. Results: FNA was diagnostic in 33 out of 45 (73%) patients with mediastinal mass. The remaining 12 required open or trucut biopsy for a diagnosis to be made. Of these 12 patients with undiagnosed mediastinal mass on FNA, eight were of lymph node origin while two turned out to be bronchogenic carcinoma and two neurogenic tumours. Majority of non-diagnostic lymph node masses on FNA (six out of eight) were eventually diagnosed to be lymphomas. No major complication was encountered as a result of the procedure. Conclusion: CT-guided fine needle aspiration is a safe procedure with reasonable yield in mediastinal tumours. However, it is not very helpful in the diagnosis of mediastinal lymphoma.

Category: Radiology
Keywords: Fine Needle Aspiration Cytology. Biopsy. CT Scan. CT Guided Biopsy. Cancer. Mediastinum.

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