Utility of image guided fine needle aspiration cytology in the evaluation of intra-abdominal and retroperitoneal lesions at a tertiary health care center in Kashmir valley


  • Shaheena Parveen Department of Pathology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Kousar Sideeq Lone Department of Social and Preventive Medicine, Governmental Medical College, Baramulla, Jammu and Kashmir, India
  • Misbah Rashid Department of Pathology, ASCOMS, Jammu, Jammu and Kashmir, India
  • Syed Besina Yasin Department of Pathology, SKIMS, Srinagar, Jammu and Kashmir, India




Abdominal and retroperitoneal masses, Computed tomography, Fine needle aspiration cytology, Image guided, Ultrasound


Background: FNAC has become an established investigation in the diagnosis of accessible and palpable lesions. Most of the intra-abdominal masses are non-palpable and even if they are palpable, the idea of their size and shape and the extent of the lesion is not possible. Therefore, various imaging modalities like ultra-sonography, computed tomography and fluoroscopy are used as a guide for fine needle aspiration nowadays. Objectives of this study were to assess the utility of image guided fine needle aspiration cytology in the diagnosis of non-palpable intra-abdominal lesions. To study the cytomorphological features of these lesions. To evaluate the sensitivity, specificity and diagnostic accuracy of image guided fine needle aspiration cytology of these lesions.

Methods: A prospective study of percutaneous aspiration biopsy of intra-abdominal masses, to evaluate its utility was undertaken in the department of pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir. FNA was performed in 183 patients.

Results: Adequate cell sample was obtained in majority of the cases (83.6%). Majority of the abdominal masses were arising from the liver (65%). Location of abdominal masses also included those arising from pancreas (12.02%), kidneys (7.65%), lymph nodes (7.65%), Gall bladder (6%) omental deposits (1.09%) and adrenal gland (0.54%). Majority of US guided FNA was done in liver masses. Overall sensitivity, specificity and diagnostic accuracy of image guided FNAC of intra-abdominal and retroperitoneal masses of the study was 100%, 100% and 93.54%, respectively.

Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.


Rani SG, Faheem N, Sai Prasad B, Sudhakar Reddy E. Efficiency of ultrasound guided aspiration cytology in deep seated lesions-a diagnostic evaluation. Int J Med Health Sci. 2012;1:2-11.

Amedee RG, Dhurandhar NR. Fine-needle aspiration biopsy. The Laryngoscope. 2001;111:1551-7.

Ansari NA, Derias NW. Origins of fine needle aspiration cytology. J Clin Pathol. 1997;50:541-3.

Reddy VB, Gattuso P, Abraham KP. Computed tomography guided fine needle aspiration biopsy of deep-seated lesions- a four year experience. Acta Cytol 1991;35:753-6.

Aftab KA, Jan GM, Wani NA. Fine needle aspiration of intra-abdominal masses for cytodiagnosis. J Indian Med Assoc. 1996;94:167-9.

Nautiyal S, Mishra RK, Sharma SP. Routine and ultrasound guided FNAC of intra-abdominal lumps-a comparative study. J Cytol. 2004;21:129-32.

Hemalatha AL, SumanaSindhuram V, Sushma S, Suma JK, Varna I, Aditya A. Ultrasound guided FNAC of abdominal-pelvic masses-the pathologists perspective. J Clin Diagnos Res. 2013;2:273-7.

Behm FG, O'Dowd GJ, Frable WJ. Fine needle aspiration effects on benign lymph node histology Am J Gin Pathol. 1984;82:195-8.

Tuladhar AS, Adhikari RC, Shrestha S, Sharma SK, Pradhan S, Shrestha A, et al. Role of USG guided FNAC in diagnosis of abdominal and thoracic lesions. Nepal Med Coll J. 2012;14:271-4.

Jha B, Shah R, Patel J. Effectiveness of image guided fine needle aspiration cytology in cases of deep seated lesions. Int J Med Sci Pub Health. 2013;2:2439-40.

Adhikari RC, Tuladhar A, Shrestha S, Sharma SK. Deep-seated thoracic and abdominal lesions: usefulness of ultrasound guided fine needle aspiration cytology, a 3-year experience. Nepal Med Coll J. 2010;12:20-5.

Biradar VB. A study of fine needle aspiration cytology in abdominal lumps (dissertation). Gulbarga. University Gulbarga; 1994.

Nóbrega J, dos Santos G. Aspirative cytology with fine-needle in the abdomen, retroperitoneum and pelvic cavity: a seven-year experience of the Portuguese Institute of Oncology, Center of Porto. Eur J Surg Oncol. 1994;20:37-42.

Nyman RS, Cappelen-Smith J, Brismar J, von Sinner W. Yield and complications in ultrasound-guided biopsy of abdominal lesions. Acta Radiol. 1995;36:485-90.

Sheikh M, Sawhney S, Dev P, Al-saeed O, Behbehani A. Deep seated thoracic and abdominal masses: usefulness of ultrasound and computed tomography guidance in fine needle aspiration cytology diagnosis. Australas Radiol. 2000;44:155-60.

Stewart CJR, Coldewey J, Stewart IS. Comparison of fine needle aspiration cytology and needle core biopsy in the diagnosis of radiologically detected abdominal lesions. J Clin Pathol. 2002;55:93-7.

Zawar MP, Bolde S, Shete SS. Correlative study of fine needle aspiration cytology and histology in intra-abdominal lumps. SMJ. 2007:4.

Reddy S, Sainath K. Fine needle aspiration cytology of intra-abdominal lesions. J Clin Diagnos Res. 2011;5:758-65.

Sharma RB, Tanya, Hiremath SS, Kumar P, Verma N, Sharma J. A study of fine needle aspiration cytology of intra-abdominal masses in and around Davangere, Karnataka. J Adv Res Biol Sci. 2013;5:290-3.

Islam T, Hossain F, Rumpa AP, Sikder NH, Bhuiyan MA, Karim E et al. Ultrasound guided fine needle aspiration cytology: a sensitive diagnostic tool for diagnosis of intra-abdominal lesions. Bangladesh Med Res Counc Bull. 2013;39:14-7.

Harter LP, Moss AA, Goldberg HI, Gross BH. Ct guided fine needle aspirations for diagnosis of benign and malignant disease. AJR. 1983;140:363-7.

Rasania A, Pandey CL, Joshi N. Evaluation of FNAC in diagnosis of hepatic lesion. J Cytol. 2007;24:51-4.

Ho CS, Tao LC, Mcloughlin MJ. Percutaneous fine needle aspiration biopsy of intra-abdominal masses. CMA J. 1978;119:1311-22.

Barbhuiya M, Shushruta B, Manisha K, Shrivastava B, Pramod KT, Gupta S. Fine needle aspiration cytology of lesions of liver and gallbladder: an analysis of 400 consecutive aspirations. J Cytol. 2014;31:20-4.

Haque S, Dilawar A, Subzwari J. Ultrasound-guided fine-needle aspiration biopsy of metastatic liver disease: a comparative assessment of histological and cytological techniques. Biomedica. 2012;28:49-51.

Zornoza J, Wallace S, Ordonezz N, Lukeman J. Fine needle asoiration biopsy of the liver. AJR. 1980;134:331-4.

Rasool MT, Lone MM, Wani ML, Afroz F, Zaffar S, Mohib-ulHaq M. Cancer in Kashmir, India: Burden and pattern of disease. J Can Res Ther. 2012;8:243-6.

Wani MA, Jan FA, Khan NA, Pandita KK, Khurshid R, Khan SH. Cancer trends in Kashmir; common types, site incidence and demographic profiles: National Cancer Registry 2000-2012. Indian J Cancer. 2014;51:133-7.

Parajuli S, Tuladhar A, Basnet RB. Ultrasound and computed tomography guided fine needle aspiration cytology in diagnosing intra-abdominal and intra-thoracic lesions. J Pathol Nepal. 2011;1:17-21.

Sautereau D, Vire O, Cazes PY. Value of sonographically guided fine needle aspiration biopsy in evaluating the liver with sonographic abnormalities. Gastroenterol. 1987;93:715-8.






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