Accuracy of Fine Needle Aspiration of Pelvic Masses, A Cyto-histological Correlation

Objective: Evaluation of diagnostic efficacy of Fine Needle Aspiration Cytology in differential diagnosis of pelvic masses and correlation between histopathologic and FNA diagnoses. Methods: In this prospective study fifty pelvic masses submitted for pathologic examination, were aspirated by fine needle and analyzed for cytological findings. Cytological findings were categorized as benign, malignant, indeterminate and non- diagnostic. Histological classification was assigned using the guidelines established by the World Health Organization (WHO). A single pathologist evaluated cytological examinations and was blinded to the histological findings of each mass. The same lesions were examined histologically and cytohistological correlation was carried out. Results: Fifty masses from 47 women constituted the study material. The average age of women was 45.7±14.7 years. In Cytological study 32 samples (64%) reported as benign and 9 of them (18%) diagnosed as malignant. Six cases (12%) were non- diagnostic and 3 FNA samples (6%) reported as indeterminate. Histological examination of the masses revealed 30 (60%) benign and 20 malignant lesions. The sensitivity and specificity of FNA cytological study of pelvic masses were 50% and 96%, respectively. The false-positive rate for pelvic masses was 11.1% and the false-negative rate was 25%. Conclusion: Cytological examination of aspirated pelvic masses could not accurately predict pelvic masses histological diagnosis in our university hospital. Since the sensitivity of the technique is not high enough therefore one should not rely on aspiration cytology alone.