Ultrasound-guided fine needle aspiration biopsy of gall bladder malignancies

Purpose: To establish the safety and efficacy of US-guided fine needle aspi ration biopsy (FNAB) in gall bladder malignancies. Material and Methods: 142 patients suspected to have gall bladder malignanc ies underwent FNAB under real-time US guidance. The most common sonographic appearances were a mass filling or replacing the gall bladder (n= 98), foc al or diffuse wall thickening (n=25) and intraluminal polypoidal mass (n=19 ). FNAB was performed with a 0.7-mm spinal needle using a free-hand techniq ue. Results: On initial FNAB, 115 patients were diagnosed to have malignancy. I n the remaining 27 patients, aspirates on first FNAB showed either inflamma tory pathology (n=14) or the sample was suspicious of malignancy (n=7), or the aspirates were non-representative (n=6). Of these 27 patients, 13 under went repeat FNAB because of the high suspicion of malignancy and 12 of them showed malignancy. The FNAB diagnosis of inflammatory disease of 7 patient s was confirmed on subsequent surgery and 8 patients were lost to follow-up . Thus, a total of 127/142 were diagnosed to have gall bladder malignancy. Adenocarcinoma was the most common malignancy (89.76%). No procedure-relate d complications were encountered, Conclusion: US-guided FNAB is a safe and accurate technique to diagnose gal l bladder malignancy. Either a repeat FNAB or surgical biopsy is recommende d when the suspicion of malignancy is high and the initial FNAB is negative .