ŞENAY YILMAZ, GÜNTÜLÜ AK, EMİNE DÜNDAR, MUZAFFER METİNTAŞ

Akciğer Lezyonu Olan Hastaların Aspirasyonsuz İnce İğne Sitolojisi ile Tanısı: 10 Vaka Raporu ile Literatür Değerlendirmesi

Periferik lenf nodu veya lezyona yönelik ince iğne aspirasyonunun (İİA) non invaziv bir inceleme yöntemi olduğu ve sitopatolojik tanı sağladığı önceki çalışmalarla gösterilmiştir. Burada geleneksel emici kuvvet uygulaması ile yapılan ince iğne aspirasyonu değil de aspirasyonsuz ince iğne sitolojisinin (AİİS) kanser teşhisinde tanı ve evrelemeye katkısını vurgulamayı amaçladık. Akciğerde kitlesi olan 10 olguda periferik lenf nodu veya akciğerdeki periferal kitlelere uygulanan AİİS'nin sonuçları değerlendirilmiştir.On hastanın (1'i kadın 9'u erkek), yaş ortalaması 59 yıl idi. Periferik lenf nodu saptanan 7 hasta ile periferik yerleşimli akciğer lezyonu olan 3 hastaya AİİS yapıldı ve yaymalar değerlendirildi. Periferik lenf nodu ve periferik kitleden AİİS yapılan 10 hastanın 2'si skuamoz hücreli karsinom, 4'ü küçük hücreli dışı akciğer karsinomu, diğer 4'ü ise malignite pozitif olarak tanı aldı. Malignite pozitif saptanan 4 hastadan 2'si bronkoskopi ile skuamoz hücreli karsinom ve küçük hücreli karsinom tanıları alırken 2'si trucut biyopsi ile skuamoz hücreli karsinom ve lenfoma tanıları aldı. Lenf nodu ve periferik lezyondan yapılan AİİS tanının yanında akciğer kanserli hastalarda evreleme açısından da fayda sağladı. Sonuç olarak periferik olarak tümör veya tümör metastazına ulaşılabilen hastalarda AİİS yapılması kolay ve etkin bir yöntemdir. Tanı yanında tümör non-rezektabilitesi değerlendirmede ve diğer ayırıcı tanılarda da faydalıdır. Bu nedenle AİİS lezyonu uygun olan ve özellikle invaziv işlemler açısından risk taşıyan hastalarda başlangıç noninvaziv tanı yöntemi olabilir. Sitoblok yöntemleriyle tanıyı artırmak mümkündür.

Diagnosis of Patients With Lung Lesions by Fine Needle Nonaspiration Cytology: Ten Cases Reports and Review of the Literature

Fine needle aspiration (FNA) for peripheral lymph node or lesion was shown a non-invasive method that provides cytopathologic diagnosis with previous studies. We aimed to emphasize the contribution of fine needle nonaspiration cytology (FNNAC) not FNA performed by traditional suction force in diagnosis and staging of cancer. The results of FNNAC performed to the peripheral lymph nodes and lesions were evaluated in 10 cases with pulmonary mass. The mean age of 10 patients (1 was female, 9 were male) was 59 years old. FNNAC was performed 7 of patients with peripheral lymph node, 3 of patients with peripheral lesion and, slides were evaluated. FNNAC was performed in 10 patients who 2 were diagnosed as squamous cell carcinoma (SQCLC), 4 were diagnosed as nonsmall cell lung carcinoma and 4 were diagnosed as positive malignancy. Two of 4 patients reported with positive malignancy were diagnosed as SQCLC and small cell carcinoma with bronchoscopy, while the other 2 were diagnosed as SQCLC and lenfoma with trucut biopsy. FNNAC performed on peripheral lymph nodes and lesions has provided benefits in terms of staging while confirmed the diagnosis. FNNAC is a simple and reliable method in patients whose tumors or tumor metastasis are available peripherally; in addition to tumor diagnosis it might be helpful for the evaluation of non-resectability and other differential diagnosis. FNNAC can be initial noninvasive diagnostic method especially in appropiate lesions and in patients with risk factors for invasive process. İt might be possible to increase the diagnosis with sytobloc methods.

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