USE OF FINE-NEEDLE ASPIRATION BIOPSY IN THE EVALUATION OF SPLENIC LESIONS IN A CANCER CENTER

Fine-needle aspiration biopsy (FNAB) of the spleen was performed on 50 patients, of whom 40 had had a previous diagnosis of malignancy (23 l ymphoproliferative disorders, 13 carcinomas, 3 melanomas, and 1 sarcom a). The cytologic diagnoses included 22 cases positive for malignancy (10 lymphomas, 9 metastatic carcinomas. 2 metastatic melanomas, and 1 sarcoma). 18 cases negative for malignancy, 4 cases suspicious for mal ignancy, and 6 nondiagnostic specimens. No major complications were as sociated with the FNAB procedure; however, one patient did develop a p neumothorax that resolved spontaneously. Subsequent splenectomy was pe rformed in 10 of the 50 cases. There were no false-positive diagnoses, and only one false-negative diagnosis, which was attributed to sampli ng error. The aspirate, showing only benign splenic parenchyma, was fr om a patient with splenomegaly and no previous diagnosis; subsequent s plenectomy showed acute myelogenous leukemia. In our study, FNAB prove d to be a safe and valuable diagnostic tool for evaluating splenic les ions in oncologic patients. (C) 1997 Wiley-Liss, Inc.