1
|
Matsumoto T, Yoshimatsu R, Miyatake K, Yamanishi T, Yamagami T. Computed tomography-guided percutaneous biopsy for retroperitoneal lesions: a systematic review and meta-analysis. MINIM INVASIV THER 2022; 31:1000-1007. [DOI: 10.1080/13645706.2022.2094710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Tomohiro Matsumoto
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Rika Yoshimatsu
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Kana Miyatake
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Tomoaki Yamanishi
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Takuji Yamagami
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Nankoku, Japan
| |
Collapse
|
2
|
Subtil JC, Alcázar JL, Betes MT, Mínguez JÁ, Zozaya FJ, Chacon E, Manzour N, Hidalgo A, Lozano MD, Muñoz-Navas M, Jurado M. Gastrointestinal Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Assessing Suspected Deep Pelvic or Abdominal Recurrence in Gynecologic Cancer: A Feasibility Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:761-765. [PMID: 30171619 DOI: 10.1002/jum.14766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/26/2018] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To assess the feasibility of gastrointestinal endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) for histologic confirmation of cancer recurrence in women with gynecologic cancer. METHODS This work was a retrospective cohort study comprising 46 consecutive women treated for gynecologic cancer and suspected of having a deep pelvic or abdominal recurrence on ultrasound imaging, computed tomography, positron emission tomography-computed tomography, or magnetic resonance imaging, evaluated at our institution from January 2010 to December 2017. Primary cancer was ovarian (n = 22), cervical (n = 13), endometrial (n = 4), sarcoma (n = 4), and other (n = 3). All women underwent EUS examinations for locating the lesion and guiding FNA. The results of FNA (benign/malignant) were assessed. Procedure-related complications were recorded. RESULTS The patients' mean age was 57.8 years. A total of 66 procedures were performed. Eleven women underwent 2 procedures; 2 women underwent 3 procedures; and 1 woman underwent 6 procedures at different times during the study period. In 1 case, no lesion was detected on the EUS assessment, and in 2 cases, FNA was not successful. Most lesions were located in the retroperitoneum or involved the intestine. Fine-needle aspiration could be performed in 63 cases (94.5%). Cytologic samples were adequate in 62 of 63 (98.4%). Recurrence was confirmed in 56 cases (90.3%) and ruled out in 6 (9.7%). No patient had any complication related to the procedure. CONCLUSIONS Endoscopic ultrasound-guided FNA is a minimally invasive, feasible, and safe technique for confirming pelvic/abdominal recurrence of gynecologic cancer.
Collapse
Affiliation(s)
- José Carlos Subtil
- Department of Gastroenterology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Juan Luis Alcázar
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Maria Teresa Betes
- Department of Gastroenterology, Clinica Universidad de Navarra, Pamplona, Spain
| | - José Ángel Mínguez
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
| | | | - Enrique Chacon
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Nabil Manzour
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Alberto Hidalgo
- Department of Obstetrics and Gynecology, Hospital Clinico San Cecilio, Granada, Spain
| | | | - Miguel Muñoz-Navas
- Department of Gastroenterology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Matías Jurado
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
| |
Collapse
|
3
|
Lin SY, Xiong YH, Yun M, Liu LZ, Zheng W, Lin X, Pei XQ, Li AH. Transvaginal Ultrasound-Guided Core Needle Biopsy of Pelvic Masses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:453-461. [PMID: 28885718 DOI: 10.1002/jum.14356] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/16/2017] [Accepted: 05/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES This study assessed the efficacy and safety of transvaginal ultrasound (US)-guided core needle biopsy (CNB) for obtaining adequate pelvic mass samples for histologic analysis and evaluated factors that may affect biopsy success. METHODS Two hundred cases underwent transvaginal US-guided CNBs for primary inoperable tumors, suspicion of metastases to the ovaries or peritoneum, recurrence, or other solid lesions in the pelvis. Biopsy samples were obtained from the pelvic cavity (67.0%), vaginal cuff or vaginal wall (17.5%), or peritoneal cake (15.5%). The potential influences of the biopsy site (pelvic cavity, vaginal cuff or vaginal wall, or peritoneal cake), vascularization, ascites, tumor size, and tumor type (inoperable, metastases, recurrence, or solid pelvic tumor) on the success of transvaginal US-guided CNB were evaluated by a univariate analysis. RESULTS Adequate samples were obtained in 192 of 200 biopsies (96.0%), of which 190 yielded successful diagnoses (95.0%). The biopsy site had a significant effect on biopsy adequacy, as there was a significantly lower probability of obtaining satisfactory specimens for histologic verification from the peritoneal cake compared to pelvic tumors and the vaginal cuff or vaginal wall (P < .01). Adequacy was also affected by tumor size (P < .05) but not by vascularization, ascites, or tumor type. No complications occurred during the biopsy procedures. CONCLUSIONS Transvaginal US-guided CNB is a safe and effective alternative to more invasive methods for evaluating pelvic lesions, such as laparoscopy and laparotomy.
Collapse
Affiliation(s)
- Shi-Yang Lin
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yong-Hong Xiong
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Miao Yun
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Long-Zhong Liu
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wei Zheng
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xi Lin
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiao-Qing Pei
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - An-Hua Li
- Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| |
Collapse
|
4
|
Gupta P, Rajwanshi A, Nijhawan R, Srinivasan R, Gupta N, Saikia UN, Dey P. Fine needle aspiration in retroperitoneal lesions. APMIS 2016; 125:16-23. [PMID: 27807894 DOI: 10.1111/apm.12627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 09/01/2016] [Indexed: 11/30/2022]
Abstract
The retroperitoneal space is a potential space extending from lumbar to the pelvic region, behind the peritoneum. It encloses many vital organs like adrenals, kidneys, ureters, pancreas, aorta and its branches, inferior vena cava and its tributaries and many lymph nodes along with loose connective tissue and fat. The literature regarding role of fine needle aspiration cytology (FNAC) for diagnosis of retroperitoneal lesions as a whole, is exceedingly limited. The present study was conducted to elucidate the spectrum of retroperitoneal lesions and to determine the diagnostic accuracy of fine needle aspiration cytology, presenting to a tertiary care referral centre. A total of 389 aspirates from retroperitoneal lesions were reviewed for clinical and radiological details. The smears were studied for the cytological diagnosis. Cytological-histological correlation was assessed and the causes for discordant diagnoses were determined. The patients' age ranged from 1 to 88 years. There were 234 (60.2%) males and 155 (39.8%) females. In 61 (15.7%) aspirations, the yield was inadequate for reporting and 328 were satisfactory. About 113 (29.0%) aspirates were from pancreatic masses alone, 97 (24.9%) from the retroperitoneal lymph nodes, 70 (17.9%) from the kidneys, 45 (11.5%) from the adrenals, 41 (10.5%) from the retroperitoneal soft tissues and 23 (5.9%) from retroperitoneal segments of the gut. There were 249 (64.0%) neoplastic lesions and 79 (20.3%) non-neoplastic lesions, the ratio being 3.1:1. Eight (2.0%) aspirates were reported as suspicious for malignancy, and 5 (1.2%) aspirates were reported as neoplastic but could not be categorized as benign or malignant. Of the neoplastic lesions, malignant neoplasms (n = 216; 87.1%) were much more common than the benign (n = 20; 8.0%), the ratio being 10.8:1. Of all the satisfactory aspirates, subsequent histopathology was available only in 33/327 (10%) cases. A positive correlation between cytological and histological diagnosis was observed in 27/33 (81.8%) cases. We believe FNAC is a useful method for an early, rapid, minimally invasive and reliable pre-operative diagnosis for retroperitoneal lesions and can often obviate the need for open surgical biopsy.
Collapse
Affiliation(s)
- Parikshaa Gupta
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Raje Nijhawan
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nalini Gupta
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
5
|
Das C, Sengupta M, Mukhopadhyay M, Saha AK. Critical clinical appraisal of the role of computed tomography-guided minimally invasive aspiration cytology in evaluation of retroperitoneal masses. Indian J Med Paediatr Oncol 2014; 35:60-5. [PMID: 25006286 PMCID: PMC4080665 DOI: 10.4103/0971-5851.133723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Context: Fine-needle aspiration (FNA) is increasing in popularity as a means of diagnosing mass lesions in retroperitoneal area. With use of radiologic guidance for needle placement, this technique is an effective way to obtain diagnostic material. Aims: The aims of the study were (1) to establish the validity and reliability of fine needle aspiration cytology in preoperative diagnosis of retroperitoneal tumor, and (2) to compare the significance of cytological diagnosis with histopathological report. Settings and Design: A prospective, cross-sectional hospital-based study. Materials and Methods: A prospective, cross-sectional study was designed on 45 cases of clinically and radiologically diagnosed retroperitoneal tumor in a tertiary care hospital. Computerized tomography (CT)-guided percutaneous FNA was performed and cytology smears were stained with May-Grünwald-Giemsa stain and conventional Papanicolaou (Pap) stain. Smears were broadly categorized into unsatisfactory, benign, suspicious of malignancy and malignant lesion. The cytological diagnosis was compared with subsequent histopathology report. Statistical Analysis: Positive and negative predictive values, diagnostic accuracy, chi-square test and others. Results: The total number of cases studied was 45, which include both epithelial tumors and mesenchymal tumors. Age group varied from 15 to 70 years. The overall sensitivity in our study to diagnose benign and malignant tumors by FNA cytology is 86% and the specificity is 96% with positive and negative predictive value of 86% and 96%, respectively. Diagnostic accuracy was 93.55% with high statistical significance (P < 0.001). Conclusions: FNA cytology is a simple, fast, reliable and less expensive method for diagnosis of various retroperitoneal neoplasms.
Collapse
Affiliation(s)
- Chhanda Das
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | | | - Ashis Kumar Saha
- Department of Surgery, B.S Medical College, Bankura, West Bengal, India
| |
Collapse
|
6
|
Mehdi G, Maheshwari V, Afzal S, Ansari HA, Ahmad I. Image-guided fine-needle aspiration of retroperitoneal masses: The role of the cytopathologist. J Cytol 2013; 30:36-41. [PMID: 23661939 PMCID: PMC3643360 DOI: 10.4103/0970-9371.107511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Retroperitoneal tumors constitute a difficult diagnostic category as they are not easily accessible. The advent of image-guided fine-needle aspiration (FNA) has resolved this problem significantly. Aims: We present a short study based on guided aspiration of retroperitoneal tumors, in which we have tried to assess the role of image-guided fine-needle aspiration cytology as a tool for pre-operative diagnosis. Materials and Methods: The study was conducted on patients diagnosed with retroperitoneal masses. FNA was performed under image guidance with the help of ultrasonography and/or computed tomography; smears were prepared and meticulously screened according to a fixed protocol. The results were analyzed to determine sensitivity, specificity, and diagnostic efficacy of cytopathological diagnosis using image-guided FNA techniques. Results: We assessed 38 patients with retroperitoneal masses. In all cases, adequate cellular material was obtained. No major complications were encountered. Statistical analysis was carried out in 35 cases; sensitivity, specificity, and diagnostic accuracy were 100% in these cases. Conclusion: FNA under image guidance should be considered a first-line diagnostic approach for retroperitoneal and other abdominal tumors, although caution should be exercised in case selection. In areas where advanced tests are not available, the cytotechnologist and cytopathologist have a very important role to play in ensuring accurate diagnoses.
Collapse
Affiliation(s)
- Ghazala Mehdi
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | | | | | | | | |
Collapse
|
7
|
Franco-Camps S, Cabrera S, Pérez-Benavente A, Díaz-Feijoo B, Bradbury M, Xercavins J, Gil-Moreno A. Extraperitoneal Laparoscopic Approach for Diagnosis and Treatment of Aortic Lymph Node Recurrence in Gynecologic Malignancy. J Minim Invasive Gynecol 2010; 17:570-5. [DOI: 10.1016/j.jmig.2010.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 03/16/2010] [Accepted: 03/18/2010] [Indexed: 10/19/2022]
|
8
|
Fischerova D, Cibula D, Dundr P, Zikan M, Calda P, Freitag P, Slama J. Ultrasound-guided tru-cut biopsy in the management of advanced abdomino-pelvic tumors. Int J Gynecol Cancer 2008; 18:833-7. [PMID: 17764453 DOI: 10.1111/j.1525-1438.2007.01015.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The goal of this study was to evaluate the accuracy and safety of ultrasound-guided tru-cut biopsy in patients with either primarily inoperable pelvic tumor, advanced tumor and compromised performance status, or recurrent pelvic tumor. Altogether, 90 patients were enrolled and only 4 were not suitable for tru-cut biopsy. The biopsy was taken either from pelvic tumor (54.6%), peritoneal visceral or parietal metastases (31.4%), or omental cake (14%). Samples were obtained transvaginally (53.5%) or transabdominally (46.5%). A diagnosis consistent with primary ovarian malignancy was made in 62.8%, metastatic ovarian involvement was found in 10.5%, and extraovarian tumor in 26.7%. The obtained tissue was adequate for histologic diagnosis in 80 out of 86 cases. In four cases, repeated biopsy was required to obtain a sufficient tissue sample. False-negative samples without tumor tissue were obtained in two cases, and those patients were referred for either laparoscopy or minilaparotomy. The diagnostic accuracy of ultrasound-guided tru-cut biopsy reached 97.7% (95% CI 91.85-99.72%). There was only one complication, a bleeding from tumor in a patient with mild thrombocytopenia, requiring laparotomy. In conclusion, ultrasound-guided tru-cut biopsy is safe, reliable, and cost-effective diagnostic method. It can be performed in an outpatient setting without the need for general anesthesia and provides an adequate specimen for histologic analysis, including immunohistochemical methods. It should, therefore, be considered as a method of choice for histologic verification of both advanced primary and recurrent abdomino-pelvic tumors.
Collapse
Affiliation(s)
- D Fischerova
- Departments of Obstetrics and Gynecology and Pathology, General Faculty Hospital, Charles University, Prague, Czech Republic.
| | | | | | | | | | | | | |
Collapse
|