Transvaginal fine needle aspiration biopsy

OBJECTIVE: To assess the role of transvaginal fine needle aspiration biopsy (FNAB) in the evaluation of palpable gynecologic masses. STUDY DESIGN: Transvaginal FNABs from 1994 to 1999 were identified from the files of Barnes-Jewish Hospital. Histologic correlation was obtained using the Pathology Department's computer database. Two pathologists reviewed th e pathologic samples. Pertinent clinical information was obtained by review ing the medical records. RESULTS: Twenty-two transvaginal FNABs from 22 patients were studied. The p atients' mean age was 59 years (range, 29-84). Most patients (77%) had a pr evious history of a gynecologic malignancy, and 73% had a previous total ab dominal hysterectomy and bilateral salpingo-oophorectomy. The size of the l esion sampled was provided in 15 cases and ranged from <1 to 5.4 cm in diam eter. The location of the mass was reported as follows: vaginal (10 cases), vaginal cuff (5), rectovaginal septum (2), cul-de-sac (1), fornix (1), vag inal apex (1), right side of pelvis (1), and not specified (1). The cytolog ic diagnoses were: negative for malignancy (10 cases), positive for maligna ncy (9) and unsatisfactory (3). Most cases (77%) had histologic correlation or clinical follow-up. There was one false negative and no false positive cytologic diagnosis. CONCLUSION: Cytologic interpretation of transvaginal FNAB is an effective t ool for the evaluation of palpable pelvic and vaginal masses. Its specifici ty and sensitivity are 100% and 88%, respectively.