DIAGNOSTIC ACCURACY OF ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION CYTOLOGY TO ASSESS MALIGNANCY IN INTRA-ABDOMINAL MASSES IN TERTIARY CARE HOSPITAL OF RAWALPINDI

Abstract

Background: Intra-abdominal masses represent a wide spectrum of benign and malignant lesions. Endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNAC) provides real-time imaging and tissue acquisition, potentially improving diagnostic yield over conventional techniques.

Objective: To evaluate the diagnostic accuracy of EUS-FNAC in differentiating malignant from non-malignant intra-abdominal masses using histopathology as the gold standard.

Methods: This cross-sectional validation study included 95 patients aged 45–70 years presenting with intra-abdominal masses at a tertiary care hospital. All underwent EUS-guided FNAC using a 22-gauge needle with both smear and cell-block preparation. Histopathological examination served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated.

Results: The mean age of participants was 58.4 ± 6.8 years; 57.9% were male and 63.1% resided in urban areas. Radiologically, 52.6% of lesions were solid, 26.3% cystic, and 21.1% mixed. EUS-FNAC correctly identified 60 malignant and 23 non-malignant lesions, with five false positives and seven false negatives. Among non-malignant cases, benign lesions (33.3%) predominated. The diagnostic performance of EUS-FNAC demonstrated a sensitivity of 89.5%, specificity of 82.1%, PPV of 92.3%, NPV of 76.7%, and overall accuracy of 87.3%.

Conclusion: EUS-FNAC is a highly accurate, minimally invasive diagnostic modality for intra-abdominal masses. Adoption of this technique can reduce the need for open biopsies and improve patient management.