Diagnostic accuracy of fine-needle aspiration cytology in persistent or recurrent gynecologic malignancies

A retrospective 7 1/4-yr study was performed to evaluate the diagnostic accuracy of fine-needle aspiration (FNA) cytology in the cell typing of persistent or recurrent gynecologic malignancies. A total of 202 aspirates were obtained from 163 patients with documented malignancies of the cervix, uterus, ovary, vulva, and vagina. Information concerning the primary tumor was obtained from surgical reports and/or medical records. In 168/202 cases (83%), the histological diagnosis, including primary tumor cell type and subtype (ex. squamous cell carcinoma, large cell keratinizing), were available. In 12/202 cases (6%), only the tumor cell type (ex. squamous cell carcinoma) was known, and in the remaining 22 cases (11%), only the location of the primary neoplasm was attainable. Aspirated sites included pelvic wall and organs (77 cases), lymph nodes (51 cases), thoracic organs (18 cases), and abdominal wall and organs (56 cases), including liver (33 cases). Of the 168 cases with known histologic diagnoses, the FNA results were positive in 109 (65%). The positive results were divided into three groups: group I, the cytologic findings were predictive of the histologic diagnoses (84 cases, 77%); group II, tumor cell subtyping was not possible on cytology (17 cases, 16%); group III, neither tumor cell typing nor subtyping was possible on cytology (8 cases, 7%). Of the 34 cases in which only the histologic tumor cell type or primary tumor location was known, 13 (38%) were positive on FNA.(ABSTRACT TRUNCATED AT 250 WORDS)