Ultrasound-guided fine needle aspiration biopsy of gall bladder malignancies.
OBJECTIVE
To establish the safety and efficacy of US-guided fine needle aspiration biopsy (FNAB) in gall bladder malignancies.


METHODS
142 patients suspected to have gall bladder malignancies underwent FNAB under real-time US guidance. The most common sonographic appearances were a mass filling or replacing the gall bladder (n=98), focal or diffuse wall thickening (n=25) and intraluminal polypoidal mass (n=19). FNAB was performed with a 0.7-mm spinal needle using a free-hand technique.


RESULTS
On initial FNAB, 115 patients were diagnosed to have malignancy. In the remaining 27 patients, aspirates on first FNAB showed either inflammatory pathology (n=14) or the sample was suspicious of malignancy (n=7), or the aspirates were non-representative (n=6). Of these 27 patients, 13 underwent repeat FNAB because of the high suspicion of malignancy and 12 of them showed malignancy. The FNAB diagnosis of inflammatory disease of 7 patients was confirmed on subsequent surgery and 8 patients were lost to follow-up. Thus, a total of 127/142 were diagnosed to have gall bladder malignancy. Adenocarcinoma was the most common malignancy (89.76%). No procedure-related complications were encountered.


CONCLUSIONS
US-guided FNAB is a safe and accurate technique to diagnose gall bladder malignancy. Either a repeat FNAB or surgical biopsy is recommended when the suspicion of malignancy is high and the initial FNAB is negative.
Department of Radiodiagnosis, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
N K
NK
Venkataramu
B P
BP
Sood
S
S
Gupta
M
M
Gulati
N
N
Khandelwal
S
S
Suri
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography