ROLE OF FINE-NEEDLE ASPIRATION IN CLINICAL MANAGEMENT OF TRANSPLANT PATIENTS

Fine-needle aspiration (FNA) of superficial and deep seated lesions ha s been used with high sensitivity and specificity in the diagnosis of neoplastic and non-neoplastic entities. However studies of FNA in post -transplant patients are virtually absent. Six hundred and seventy-fou r allograft recipients (cardiac 288, renal 250, lung 131 and heart-lun g 5) were reviewed. A total of 30 (25 heart 4 lungs and 1 renal transp lant) patients underwent an FNA procedure. There were 26 males and 4 f emales. Ages ranged from 18-63 yr (mean 48 yr). The most common entity aspirated was post-transplant lymphoproliferative disorder (PTLD) in 12 cases, followed by inflammatory lesions in 10 cases, malignant epit helial neoplasms in 3 cases, and 1 case each of malignant mesenchymal tumor pulmonary infarction, hamartoma of liver fatty changes of liver and a benign vascular lesion. Surgical or autopsy tissue was available in 19 cases (63.3%). There was an agreement between tissue diagnosis and FNA material in 18 cases (94.7%). One (5.2%) false negative case w as recorded. This was a liver aspirate showing benign liver elements, which a surgical biopsy proved to be a bile duct hamartoma. No false p ositive cases were recorded. FNA is a highly sensitive and specific di agnostic tool in the management of post-transplant patients.