Diagnosis of deep pelvic masses on a gynaecology service: Trans-vaginal ultrasound-guided needle aspiration of pelvic solid and cystic lesions

Aust N Z J Obstet Gynaecol. 2017 Apr;57(2):197-200. doi: 10.1111/ajo.12585. Epub 2017 Mar 2.

Abstract

Objectives: Women with undiagnosed pelvic lesions are often referred for evaluation and treatment. Transvaginal ultrasound-guided fine needle aspiration (TVUS-FNA) biopsy can assist in making management decisions. We describe our experience with this modality.

Methods: We performed a retrospective chart review of all women who had a TVUS-FNA biopsy between January 2004 and December 2014. Charts were reviewed for clinicopathologic information. The pathologic results of the TVUS-FNA were compared with the final diagnosis.

Results: Fifty-nine women underwent TVUS-FNA; the median age was 66 years (range 27-85). Thirty-three lesions were evaluated by fine-needle aspiration biopsy of the solid structure and 26 by aspiration of fluid for cytology. Pathologic feasibility rate was 88% (52/59). Of those with evaluable tissue, the sensitivity of the procedure was 100% and the specificity 92%. Considering the seven inconclusive results, the procedure had sensitivity of 88% (29/33) and specificity of 88% (23/26). Overall accuracy of TVUS-FNA for this patient cohort was 85%. No patient characteristics were found to distinguish between accurate and inaccurate or inconclusive TVUS-FNA result. No complications were noted.

Conclusions: TVUS-FNA offers an excellent modality for the diagnosis and management of deep pelvic lesions otherwise not amenable for histologic evaluation.

Keywords: biopsy; cytology; pathology; pelvic lesion; ultrasound guided.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cysts / diagnosis
  • Cysts / pathology
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration* / adverse effects
  • Female
  • Genital Neoplasms, Female / diagnosis*
  • Genital Neoplasms, Female / pathology
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / pathology
  • Pelvic Neoplasms / diagnosis*
  • Pelvic Neoplasms / pathology
  • Retrospective Studies
  • Sensitivity and Specificity
  • Vagina