Normal 0 false false false EN-US X-NONE AR-SA
Results:
The patient's age ranged from 30 to 70 years,
and the commonest age group was between 50- 60 years.
Clinical complaint:
Abdominal/pelvic pain and discomfort was present in 34.9% of patients,
25.6% presented by abdominal distension and swelling,
23.3% by both abdominal distension and pain and 16.3% mainly with loss of weight or cachexia.
Type of the lesion:
Purely solid lesions represented only in 5 patients (2 lymphoma and 3 metastases),
purely cystic lesions represented only in 10 patients (8 tubo-ovarian abscesses and 2 cystadenoma),
while mixed solid/cystic complex lesions were present in the rest of the patients (85).
Technical factors:
· Type of biopsy:
-FNAC ( together with cell block) was done in all 100 patients.
-Core biopsy was done in 40 patients (including the purely solid lesions (5) and (35) patients with the mixed complex lesions.
· Size of the needle :
-FNAC: 22 gauge needle was used in all patients yielding adequate sample for both smears ( put in 95% concentrated alcohol) and cell block (put in mixture 1:1 alcohol/formalin).
-Core biopsy: 18-gauge needle was used in all 40 patients yielding adequate tissue sample for histopathology and IHC.
· Image-guidance:
-Ultrasound guided biopsy was done in 90 patients,
including only one by transvaginal route while the rest by transabdominal route.
-CT-guided biopsy was done in 10 patients.
· Number of passes:
-In all patients,
the sample was taken twice in the same setting for both FNAC (& cell block) and core biopsy.
· Diagnostic yield:
-The diagnostic yield for FNAC ( & cell block) for the whole 100 patients was 98% as in two cases the smears were reported by the pathologist as hypocellular while their cell block was predominantly bloody though suggested being probably low grade neoplasia and recommended excision.
And,
they were finally diagnosed by excisional biopsy as sclerosing stromal tumor and the other one as low grade endometroid carcinoma.
In all other 98 cases,
the pathological reports for the biopsy were matching with the final diagnosis.
-The diagnostic yield of core biopsy was 100% in all 40 cases matching with the final diagnosis.
· Pathological diagnosis: (Table 1)
-Included 80 malignant and 20 benign lesions.
- Malignant lesions included 33 primary ovarian tumors (41.2%),
45 metastases (56.2%) and 2 lymphoma (2.5%).
(Fig.1-7)
-Benign lesions included 8 tubo-ovarian abscesses (40%),
3 endometriomas (15%),
5 fibroma/fibrothecoma(25%),3 cystadenoma (15%) and 1 sclerosing stromal tumor (5%).
(Fig.8,9)
Normal 0 false false false EN-US X-NONE AR-SA
Table 1 showing final pathological diagnosis :
Final pathological diagnosis
|
Number
|
%
|
Ovarian serous cystadenocarcinoma .
|
12
|
12
|
Ovarian mucinous cystadenocarcinoma.
|
10
|
10
|
Ovarian papillary cystadenocarcinoma.
|
5
|
5
|
Ovarian low grade endometroid carcinoma.
|
2
|
2
|
Ovarian undifferentiated carcinoma.
|
2
|
2
|
Ovarian adenocarcinoma (Not Otherwise Specified,
NOS).
|
2
|
2
|
Metastatic adenocarcinoma from gastric (25) and colonic (5) primary.
|
30
|
30
|
Metastatic from breast cancer.
|
10
|
10
|
Metastatic from cholangiocarcinoma.
|
1
|
1
|
Metastatic from endometrial carcinoma.
|
4
|
4
|
Lymphoma
|
2
|
2
|
Tubo-ovarian abscess
|
8
|
8
|
Fibroma/fibrothecoma.
|
5
|
5
|
Endometrioma.
|
3
|
3
|
Serous cystadenoma
|
3
|
3
|
Sclerosing stromal tumor
|
1
|
1
|
Total
|
100
|
100.0
|
Normal 0 false false false EN-US X-NONE AR-SA
Complications:
· No significant complications encountered in the current study apart from minimal localized hematoma that was found around a left ovarian solid lesion post-core biopsy taken under CT-guidance.
Follow up of the patient by ultrasound and CT over 24 hours showed no progression in the amount of the collection and the patient was stable and no further intervention was needed.