Akciğer Lezyonu Olan Hastaların Aspirasyonsuz İnce İğne Sitolojisi ile Tanısı: 10 Vaka Raporu ile Literatür / Değerlendirmesi Diagnosis of Patients with Lung Lesions By Fine Needle Nonaspiration Cytology: Ten Cases Reports And Review of The Literature

Yıl 2017, Cilt: 39 Sayı: 1, 36 - 42, 22.03.2017

Şenay Yılmaz Güntülü Ak Emine Dündar Muzaffer Metintaş

https://doi.org/10.20515/otd.301590

Öz

Özet: Periferik lenf nodu veya lezyona yönelik ince
iğne aspirasyonunun (İİA) non invaziv bir inceleme yöntemi olduğu ve
sitopatolojik tanı sağladığı önceki çalışmalarla gösterilmiştir. Burada
geleneksel emici kuvvet uygulaması ile yapılan ince iğne aspirasyonu değil de
aspirasyonsuz ince iğne sitolojisinin (AİİS) kanser teşhisinde tanı ve
evrelemeye katkısını vurgulamayı amaçladık. Akciğerde kitlesi olan 10 olguda
periferik lenf nodu veya akciğerdeki periferal kitlelere uygulanan AİİS’nin
sonuçları değerlendirilmiştir. On hastanın (1’i kadın 9’u erkek), yaş
ortalaması 59 (35-84) yıl idi. Periferik lenf nodu saptanan 7 hasta ile
periferik yerleşimli akciğer lezyonu olan 3 hastaya AİİS yapıldı ve yaymalar
değerlendirildi. Periferik lenf nodu ve periferik kitleden AİİS yapılan 10
hastanın 2’si skuamoz hücreli karsinom, 4’ü küçük hücreli dışı akciğer
karsinomu, diğer 4’ü ise malignite pozitif olarak tanı aldı. Malignite pozitif
saptanan 4 hastadan 2’si bronkoskopi ile skuamoz hücreli karsinom ve küçük hücreli
karsinom tanıları alırken 2‘si trucut biyopsi ile skuamoz hücreli karsinom ve
lenfoma tanıları aldı. Lenf nodu ve periferik lezyondan yapılan AİİS tanının
yanında akciğer kanserli hastalarda evreleme açısından da fayda sağladı. Sonuç
olarak periferik olarak tümör veya tümör metastazına ulaşılabilen hastalarda
AİİS yapılması kolay ve etkin bir yöntemdir. Tanı yanında tümör
non-rezektabilitesi değerlendirmede ve diğer ayırıcı tanılarda da faydalıdır.
Bu nedenle AİİS lezyonu uygun olan ve özellikle invaziv işlemler açısından risk
taşıyan hastalarda başlangıç noninvaziv tanı yöntemi olabilir. Sitoblok
yöntemleriyle tanıyı artırmak mümkündür.

Anahtar Kelimeler: aspirasyonsuz
ince iğne sitolojisi, periferik lenf nodu, periferik akciğer lezyonu

Abstract: Fine needle aspiration (FNA) for peripheral lymph node or
lesion was shown a non-invasive method that provides cytopathologic diagnosis
with previous studies. We aimed to emphasize the contribution of fine needle
nonaspiration cytology (FNNAC) not FNA performed by traditional suction force
in diagnosis and staging of cancer. The results of FNNAC performed to the
peripheral lymph nodes and lesions were evaluated in 10 cases with pulmonary
mass. The mean age of 10 patients (1 was female, 9 were male) was 59 (35-84)
years old. FNNAC was performed 7 of patients with peripheral lymph node, 3 of
patients with peripheral lesion and, slides were evaluated. FNNAC was performed
in 10 patients who 2 were diagnosed as squamous cell carcinoma (SQCLC), 4 were
diagnosed as nonsmall cell lung carcinoma and 4 were diagnosed as positive
malignancy. Two of 4 patients reported with positive malignancy were diagnosed
as SQCLC and small cell carcinoma with bronchoscopy, while the other 2 were
diagnosed as SQCLC and lenfoma with trucut biopsy. FNNAC performed on peripheral
lymph nodes and lesions has provided benefits in terms of staging while
confirmed the diagnosis. FNNAC is a simple and reliable method in patients
whose tumors or tumor metastasis are available peripherally; in addition to
tumor diagnosis it might be helpful for the evaluation of non-resectability and
other differential diagnosis. FNNAC can be initial non-invasive diagnostic
method especially in appropiate lesions and in patients with risk factors for
invasive process. İt might be possible to increase the diagnosis with cytobloc
methods.

Keywords: fine needle
nonaspiration cytology, peripheral lymph node, peripheral lung lesion

Anahtar Kelimeler

aspirasyonsuz ince iğne sitolojisi, periferik lenf nodu

Kaynakça

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