Fine Needle Aspiration Cytology in Lesions of Gall Bladder - Experience in a Primary Care Setting

Aims: In certain regions of India, cancer of gall bladder (GBCa) is a common form of malignancy. In the Gangetic belt, its incidence is up to 10 times greater as compared to some other parts of the country. The aim of the present study is to study the diagnostic utility of guided fine needle aspiration cytology (FNAC) in patients of carcinoma of gall bladder. Whether use of this technique can help in segregating patients requiring palliative care only, was also analyzed. The demographic profile of these patients was also studied in a primary care setting.

Study Design: All patients referred with a gall bladder mass underwent guided fine needle aspiration procedure for purpose of establishing a morphological diagnosis. Ultrasonographic examination was used for cancer staging and delineating inoperable cases.

Place and Duration of Study: The study was conducted at Ama diagnostic centre, Lucknow, in collaboration with the department of Pathology, Integral Institute of Medical Sciences, Lucknow, India. The period of study is from August 2010 to March 2016.

Methodology: FNAC was performed under ultrasound guidance on all patients having a gall bladder mass. Clinical details of the patients were recorded and their demographic profile was studied.

Results: Forty five patients having a gall bladder mass underwent FNAC for diagnostic purposes. Adequate material was obtained in 44 patients. It was possible to provide a definite diagnosis in 38 cases (86.3% of cases). Adenocarcinoma NOS was the commonest diagnosis (86.8% of cases). Amongst patients with malignancy, 73.7% of cases were in advanced stage of the disease. Palliative care represents suitable treatment option in such patients in our clinical set up.

Conclusion: Utilizing guided FNAC, it was possible to provide a definite diagnosis of malignancy in 86.3% of cases. It was also possible to segregate patients requiring either definitive or palliative treatment.