ASPIRATION CYTOLOGY OF OVARIAN CYSTS AND CYSTIC NEOPLASMS - A STUDY OF 235 ASPIRATES

OBJECTIVE: To assess the diagnostic value of aspiration cytology in in dividual cystic lesions of the ovary. STUDY DESIGN: During a 42-month period, 235 cystic ovarian lesions were investigated by fine needle as piration with cytologic examination (FNA). RESULTS: Almost 56% (131/23 5) of the aspirates weve devoid of diagnostic cells. The 104 diagnosti c aspirates comprised 49 follicular cysts, 4 endometriotic cysts, 45 n eoplastic lesions and 6 paraovarian/paratubal cysts. Cyst fluid estrad iol (E2) content >20 nmol/L identified an additional 43 follicular cys ts. Histologic examination of the ovarian lesions with acellular cyst fluid containing low E2 revealed 2 corpus luteum hematomas, 1 atretic follicular cyst, 7 endometriotic cysts and 27 serous/mucinous epitheli al tumors. The remaining 51 lesions were composed of other entities. A lthough the specificity of FNA Jot most non-follicular cystic ovarian lesions approaches 100%, the sensitivity ranged from 36% for endometri otic cysts to 83% for proliferating/malignant serious tumors. CONCLUSI ON: Prior to FNA of the ovary in an individual patient, consideration should be given to the likely diagnosis, the limitations of the techni que and the high false negative rate for nonfollicular cystic lesions.