Clinical value of image-guided fine needle aspiration of retroperitoneal masses and lymph nodes in gynecologic oncology.
OBJECTIVE
Evaluation of the sensitivity and specificity of fine needle aspiration of retroperitoneal masses and lymph nodes in gynecologic oncology.


METHODS
Retrospective study of 101 punctures administered to 84 patients aged 23-86 years. The method's sensitivity and specificity were evaluated by clinical follow-up.


RESULTS
A satisfactory sampling was obtained in 89.1% of punctures, and a cytological diagnosis was made in 88.1%. The size of the lymph nodes punctured was less than 14 mm in 46.5%. This test has a sensitivity of 87.5%, specificity of 88.9%, positive predictive value of 98%, negative predictive value of 53.3%, and accuracy of 87.7%. Four patients presented complications: pain (2), hematoma (1), and right ureteral perforation (1).


CONCLUSIONS
The fine needle aspiration technique has excellent positive predictive value and low morbidity. As a method of visualization, CT-scan, in combination with lymphography, allows the location of small lesions and the definition of their internal structures. The weak negative predictive value of fine needle aspiration might be correctible by laparoscopy-directed biopsy, and its potential is clearly ensured by the development of techniques for locating sentinel lymph nodes.
Sauthier
Philippe G
PG
Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, CHUM-Hospital Notre-Dame, 1560 Sherbrooke Street East, Montreal, Quebec, Canada H2L 4M1. philippe.sauthier@umontreal.ca
Bélanger
Raymond
R
Provencher
Diane M
DM
Gauthier
Philippe
P
Drouin
Pierre
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods* / Q000592:standards; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D015203:Reproducibility of Results; D012186:Retroperitoneal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity