UTILIZATION OF FINE-NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF NEOPLASTIC SUPERIOR VENA-CAVAL SYNDROME

Superior vena caval syndrome often presents as an acute or subacute on cologic emergency that requires immediate action, usually with high-do se radiotherapy. With improved chemotherapeutic regimens for various m alignancies, prompt and appropriate treatment of the syndrome is possi ble. Tissue diagnosis, therefore, is pursued, but invasive procedures are commonly associated with technical difficulties and complications. We find fine-needle aspiration biopsy a rapid, highly reliable, and w ell-tolerated procedure in selected situations and herein report 17 pa tients with initial presentation of superior vena caval syndrome effic aciously diagnosed with fine-needle aspiration cytology. The cell type s were eight lung small-cell carcinomas, four poorly differentiated ad enocarcinomas, true undifferentiated large-cell carcinomas, and one ea ch of malignant large-cell lymphoma, myxoid liposarcoma, and thymic la rge-cell neuroendocrine carcinoma. Further experience, however; is war ranted with this widely available procedure. Diagn. Cytopathol. 1998;1 9:84-88. (C) 1998 Wiley-Liss, Inc.