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Clinical value of image-guided fine needle aspiration of retroperitoneal masses and lymph nodes in gynecologic oncology.

Sauthier PG, Bélanger R, Provencher DM, Gauthier P, Drouin P

Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, CHUM-Hospital Notre-Dame, 1560 Sherbrooke Street East, Montreal, Quebec, Canada H2L 4M1. philippe.sauthier@umontreal.ca

OBJECTIVE: Evaluation of the sensitivity and specificity of fine needle aspiration of retroperitoneal masses and lymph nodes in gynecologic oncology. METHODS: Retrospective study of 101 punctures administered to 84 patients aged 23-86 years. The method's sensitivity and specificity were evaluated by clinical follow-up. RESULTS: A satisfactory sampling was obtained in 89.1% of punctures, and a cytological diagnosis was made in 88.1%. The size of the lymph nodes punctured was less than 14 mm in 46.5%. This test has a sensitivity of 87.5%, specificity of 88.9%, positive predictive value of 98%, negative predictive value of 53.3%, and accuracy of 87.7%. Four patients presented complications: pain (2), hematoma (1), and right ureteral perforation (1). CONCLUSIONS: The fine needle aspiration technique has excellent positive predictive value and low morbidity. As a method of visualization, CT-scan, in combination with lymphography, allows the location of small lesions and the definition of their internal structures. The weak negative predictive value of fine needle aspiration might be correctible by laparoscopy-directed biopsy, and its potential is clearly ensured by the development of techniques for locating sentinel lymph nodes.

Published 19 September 2006 in Gynecol Oncol, 103(1): 75-80.
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