Fine needle aspiration cytology in xanthogranulomatous cholecystitis, gallbladder adenocarcinoma and coexistent lesions

OBJECTIVE: To evaluate the diagnostic efficacy of fine needle aspiration cy tology (FNAC) in gallbladder mass lesions and to explore the possibility Of overlooking malignancy in coexistent adenocarcinoma with xanthogranulomato us cholecystitis (XGC) on fine needle aspiration smears. STUDY DESIGN: In a retrospective, seven-year study, ultrasound-guided needl e aspirates from 25 histologically proven cases of gallbladder adenocarcino ma, II cases of gallbladder adenocarcinoma associated with XGC and 20 cases of XGC were evaluated for the presence of mesotheliumlike, foam, inflammat ory and multinucleate giant cells; pink, granular background; bile; and deg enerated cells, along with atypical or frankly malignant cells. Detailed cl inical findings were retrieved from the records. RESULTS: The overall sensitivity of detecting carcinoma was 90.63% and spec ificity 94.74%. The sensitivity of detecting malignancy teas 80% when adeno carcinoma was associated with XGC. CONCLUSION: FNAC plays an important role in making the preoperative diagnos is of adenocarcinoma, XGC and coexistent lesions. The, probability of detec ting malignancy is greater than with XGC in coexistent lesions. Thus, a pre operative FNAC diagnosis would help in determining the urgency of treatment and in planning for the surgical procedure ill gallbladder lesions.