Background: Preoperative cytodiagnosis of ovarian masses is a difficult process, and sampling of pelvic masses is quite easier after the improvement of imaging techniques. Though histopathology is the gold standard, fine-needle aspiration cytology (FNAC) under ultrasound (US) guidance can be a valuable tool for pre-operative diagnosis of ovarian lesions, especially in the hands of an experienced pathologist. Objective: The present study was performed to evaluate the role of US-guided FNAC in pre-operative cytological diagnosis of ovarian masses in comparison with histopathology, and to assess the pitfalls and limitations of cytological interpretation. Materials and Methods: This study was conducted over a 2-year period on 70 cases of ovarian masses, which were evaluated by US-guided FNAC. Sensitivity, specificity and diagnostic efficacy were calculated using histopathology as gold standard. Results: On cytological evaluation, non-neoplastic cysts, and benign and malignant ovarian tumours were diagnosed in 8, 18 and 40 cases, respectively. On histopathology, 62 cases were concordant with cytology. Sensitivity and specificity were 95.23 and 95.83%, respectively, in the present study. Diagnostic accuracy was 93.94% in respect to the correct diagnosis. Cytohistological discrepancies and limitations of the study are discussed. Conclusion: US-guided FNAC has proved as a quick, economic and safe procedure in diagnosing ovarian masses with brilliant accuracy.

1.
Mehdi G, Maheshwari V, Afzal S, Ansari HA, Ansari M: Image-guided fine-needle aspiration cytology of ovarian tumours: an assessment of diagnostic efficacy. J Cytol 2010;27:91-95.
2.
Khan N, Afroz N, Aqil B, Khan T, Ahmed I: Neoplastic and non-neoplastic ovarian masses: diagnosis on cytology. J Cytol 2009;26:129-133.
3.
Uguz A, Ersoz C, Bolat F, Gokdemia A, Vardar MA: Fine needle aspiration cytology of ovarian lesions. Acta Cytol 2005;49:144-148.
4.
Porter B, Krap W, Forsberg L: Percutaneous cytodiagnosis of abdominal masses by ultrasound guided fine needle aspiration biopsy. Acta Radiol Diagn (Stockh) 1981;22:663-668.
5.
Wojcik EM, Selvaggi SM: Fine needle aspiration cytology of cystic ovarian lesions. Diagn Cytopathol 1994;11:9-14.
6.
Dordoni D, Zaglio S, Zucca S, Favalli G: The role of sonographically guided aspiration in the clinical management of ovarian cysts. J Ultrasound Med 1993;12:27-31.
7.
Ferran A, Gallardo J, Padilla C, Combalia N, Mellado F, Rey M: Fine needle aspiration of benign adnexal lesions. Acta Cytol 1995;39:291.
8.
Geier GR, StreckerJR: Aspiration cytology and E2 content in ovarian tumors. Acta Cytol 1981;25:400-406.
9.
Salehpour S, Zhaam H, Panah RT: Laparoscopic aspiration of ovarian cysts. Med J Iran Hosp 2002;4:42-44.
10.
Goel S, Agarwal D, Goel N, Naim M, Khan T, Ekrammulah: Ultrasound guided fine needle aspiration cytology in ovarian neoplasms: an assessment of diagnostic accuracy and efficacy and role in clinical management. Internet J Pathol 2011;11.
11.
Bandyopadhyay A, Chakrabarti J, Chowdhury AR, Bhattacharya A, Bhattachrya P, Chowdhury MK: Fine needle aspiration cytology of ovarian tumours with histological correlation. J Cytol 2012;29:35-40.
12.
Nunez C, Diaz JI: Ovarian follicular cysts: a potential source of false-positive diagnoses in ovarian cytology. Diagn Cytopathol 1992;8:532-537.
13.
Kruezer GE, Paradowski T, Wurche KD, Flenker H: Neoplastic or non-neoplastic ovarian cyst? The role of cytology. Acta Cytol 1995;39:882-886.
14.
Ganjie P, Dickinson B, Harrison TA, Nassiri M, Lu Y: Aspiration cytology of neoplastic and non-neoplastic ovarian cysts: is it accurate? Int J Gynecol Pathol 1996;15:94-101.
15.
Moran O, Menczer J, Gijlad BB, Lipitz S, Goor E: Cytological examination of ovarian cyst fluid for the distinction between benign and malignant tumors. Obstet Gynecol 1993;82:444-446.
16.
Roy M, Bhattacharya A, Roy A, Sanyal S, Sangal MK, Dasgupta S, et al: Fine needle aspiration cytology of ovarian neoplasms. J Cytol 2003;20:31-35.
17.
Nadji M, Greening SE, Sevin BU: Fine needle aspiration cytology in gynecologic oncology. II. Morphologic aspects. Acta Cytol 1979,23:380-388.
18.
Orell SR, Steratt GF, Walters MNI, Whitaker D (eds): Fine Needle Aspiration Cytology, ed 4. New Delhi, Elsevier, 2005.
19.
Higgins RV, Matkins JF, Marroum MC: Comparison of fine-needle aspiration cytologic findings of ovarian cysts with ovarian histologic findings. Am J Obstet Gynecol 1998;180:550-553.
20.
Ehya H, Lang WR: Cytology of granulosa cell tumor of the ovary. Am J Clin Pathol 1986;85:402-405.
21.
Rao S, Sadiya N, Joseph LD, Rajendiran S: Role of scrap cytology in ovarian neoplasms. J Cytol 2009;26:26-29.
22.
Kiyokawa T, Young RH, Scully RE: Krukenberg tumors of the ovary: a clinicopathologic analysis of 120 cases with emphasis on their variable pathologic manifestations. Am J Surg Pathol 2006;30:277-299.
23.
Demopoulos RI, Touger L, Dubin N: Secondary ovarian carcinoma. A clinical and pathological evaluation. Int J Gynecol Pathol 1987;6:166-175.
24.
Lagendijk JH, Mulink H, Van Diest PJ, Meijer GA, Meijer CJ: Tracing the origin of adenocarcinomas with unknown primary. Using immunohistochemistry: differential diagnosis between colonic and ovarian carcinomas as primary sites. Human Pathol 1998;29:491-497.
25.
Martinez-Onsurbe P, Ruiz Villaespesa A, Sanz Anquela JM, Valenzuela Ruiz PL: Aspiration cytology of 147 adnexal cysts with histologic correlation. Acta Cytol 2001;45:941-947.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.