Background: Fine-needle aspiration cytologic technique
(FNAC), a method to detect malignancy for undetermined pulmonary
nodules, may have a high potential to spread malignant cells from the
tumor to the pleural cavity.
Objective: The authors
assessed malignant cell spread through the needle tract following FNAC
for peripheral lung carcinoma.
Materials and methods:
Lung lobes resected from 20 patients during the treatment of lung
carcinoma were examined. The visceral pleura over the lung carcinoma
was irrigated by heparinized saline solution to clean the surface, and
then irrigated before FNAC and irrigated following FNAC to collect
cells on the visceral pleura. FNAC was performed once for each tumor.
Papanicolau’s method was employed for cytologic examination.
Results: There were 15 specimens of adenocarcinoma, 4
specimens of squamous cell carcinoma, and 1 specimen of atypical
carcinoid. The maximum diameter of the specimens ranged from 10 to 60
mm (median, 25 mm). Pleural indentation was observed in 15 samples. All
results of FNAC were positive and matched the histologic diagnosis.
Pre-FNAC specimens revealed a positive malignancy rate of 10% (2 of
20), but post-FNAC specimens had a rate of 60% (12 of 20;
p = 0.002)
Conclusion: FNAC has the potential to
spread malignant cells to the pleural space. Further study is needed to
determine the clinical significance of the spread of malignant cells in
the pleural space.