ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION CYTOLOGY OF MALIGNANT GALLBLADDER MASSES

OBJECTIVE: To determine the accuracy and reliability of ultrasound (LS S)-guided fine needle aspiration cytology (FNAC) over blind aspiration in gallbladder masses. STUDY DESIGN: We performed FNAC in 107 cases o f carcinoma of the gallbladder; blind aspiration was done in 72 patien ts (66.36%) and US-guided aspiration in 36 (33.64%). In cases where FN AC after the first aspiration showed the aspirate to be inflammatory, acellular (inconclusive) or suspicious for malignancy, FNAC was repent ed under US guidance. Diagnosis was later confirmed by histopathology in all cases. RESULTS: After the first aspiration, gallbladder maligna ncy was confirmed in 77 (71.96%) cases. Of these 77 cases, 34 underwen t US-guided aspiration, and the remaining 43 underwent blind aspiratio n. Cases with inflammatory or acellular (inconclusive) aspirates or th at were suspicious for malignancy after the first aspiration underwent a second aspiration under ultrasonic guidance. On the second aspirati on of 30 cases, 16 (53.33%) proven to be of adenocarcinoma, 7 (23.33%) were suspicious for malignancy, 5 (16.66%) were inflammatory, and 2 ( 6.66%) were acellular. Diagnosis was later confirmed by histopathology in all cases. US-guided FNAC had diagnostic accuracy of 95% as compar ed to 60% on blind aspiration. There was no major complication or need le tract recurrence of the disease. CONCLUSION: US-guided FNAC is safe , rapid, reliable, cost-effective and accurate in diagnosing gallbladd er carcinoma.