Fine-needle aspiration cytology versus open biopsy for evaluation of chronic epididymal lesions: a prospective study.
OBJECTIVE
To compare the efficacy of fine-needle aspiration cytology (FNAC) with that of open biopsy in the evaluation of chronic epididymal lesions.


METHODS
Forty men evaluated for chronic epididymal lesions were studied. Men aged >25 years who did not intend to father any more children and had had local symptoms for >6 weeks were included. Of these 40 men, 23 who satisfied the above criteria were subjected to FNAC and open biopsy. The slides were reviewed by two independent pathologists. The sensitivity, specificity and positive predictive value of FNAC were compared with the results of open biopsy.


RESULTS
Tuberculous epididymitis was the commonest cause of chronic epididymal lesions, followed by non-specific epididymitis, sperm granuloma, epdidymal cyst and normal epididymis. The sensitivity and specificity of FNAC for the diagnosis of tuberculous epididymitis were 87% and 93%, respectively. For the diagnosis of non-specific epididymitis, FNAC was 100% sensitive and 100% specific. The positive predictive value was 87% for the diagnosis of both tuberculous and non-specific epididymitis.


CONCLUSIONS
FNAC has an overall sensitivity and specificity of 90% for diagnosing chronic epididymal lesions, with a positive predictive value of 87.5%. It is a valuable tool for evaluating chronic epididymal lesions. We suggest that FNAC should be the first-choice investigation for establishing the histopathological diagnosis of epididymal lesions.
Viswaroop
Bobby
B
Department of Urology, Christian Medical College, Vellore, India.
Johnson
Prakash
P
Kurian
Susy
S
Chacko
Ninan
N
Kekre
Nitin
N
Gopalakrishnan
Ganesh
G
D000328:Adult; D044963:Biopsy, Fine-Needle; D002908:Chronic Disease; D004822:Epididymis / Q000473:pathology*; D004823:Epididymitis / Q000473:pathology*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013733:Testicular Diseases / Q000473:pathology*