Aspiration cytology of 147 adnexal cysts with histologic correlation.
OBJECTIVE
To assess the usefulness of cytology in the diagnosis of 147 histologically established adnexal cysts.


METHODS
Retrospective, macro-microscopic study based on fluid aspirated from 132 ovarian and 15 extraovarian cysts and projected as a cytohistologic correlation.


RESULTS
Typical macroscopic features were identified in 76% of endometriotic cysts, in 53% of mucinous neoplasms and in 67% of dermoid cysts. Cytology helped to identify 67% of nonneoplastic and 56% of neoplastic cysts. The lowest diagnostic sensitivities were observed in functional cysts and benign serous neoplasms (50%), while the highest were shown by endometriotic cysts (76%) and malignant epithelial neoplasms (71%). Inadequate samples were obtained from all types of cysts, even malignant ones (two mucinous cystadenocarcinomas). Diagnostic cytology was useless in extraovarian cysts (33% sensitivity). An adult granulosa cell tumor was erroneously diagnosed as a follicular cyst by cytologic examination.


CONCLUSIONS
Examination of the cyst fluids obtained by aspiration demonstrated low sensitivity, with 43% of inadequate samples obtained from all types of cysts. Malignant cystic neoplasms may be overlooked in inadequate samples. Our study also revealed that specificity in this type of analysis is high in inadequate samples, provided that the technique is carried out correctly.
Martínez-Onsurbe
P
P
Department of Pathology and of Obstetrics and Gynecology, Príncipe de Asturias Hospital, Alcalá de Henares, Medical College, University of Alcalá de Henares, Madrid, Spain.
Ruiz Villaespesa
A
A
Sanz Anquela
J M
JM
Valenzuela Ruiz
P L
PL
D000232:Adenofibroma / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D003536:Cystadenocarcinoma / Q000473:pathology; D003537:Cystadenoma / Q000473:pathology; D003884:Dermoid Cyst / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D006106:Granulosa Cell Tumor / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D010048:Ovarian Cysts / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology*; D010053:Ovary / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013798:Thecoma / Q000473:pathology