Cytopathologic analysis of paratracheal masses: a study of 737 cases with clinicoradiologic correlation.

Published

Journal Article

OBJECTIVE: To analyze the cytopathologic findings of a series of paratracheal space (PTS) masses in the context of clinicoradiologic correlation. STUDY DESIGN: Retrospective review of our cytopathology files revealed 131 cases of PTS lesions in a 14-year period (1991-2005). Cytologic material was obtained under radiologic guidance. Radiologic findings, clinical data and subsequently performed tissue biopsies were reviewed and correlated. RESULTS: Radiologic imaging disclosed masses in the PTS ranging from 1 to 7 cm. Of the 131 cases, 103 (79%) were deemed diagnostic. Of these, 41 (40%) revealed nonneoplastic lesions, and 62 (60%) yielded malignant neoplasms. Nonneoplastic entities included: 31 (73%) hyperplastic lymph nodes and 10 (24%) sarcoidosis. Of the malignant cases, 45 (73%) were metastatic tumors: adenocarcinoma (ACA) 19, small cell carcinoma 12, squamous cell carcinoma (SQCC) 11 and other tumors, from lung 34, esophagus 4 and other sites. Malignant neoplasms from local spread included lung non-small cell carcinoma 6, SQCC 3 and ACA 3, papillary thyroid carcinoma 3 and other 2. CONCLUSION: Fine needle aspiration (FNA) of PTS has a high diagnostic yield (79%) with a sensitivity of 97% and specificity of 100%. The most common diagnosis is a malignant tumor (60%), with metastatic carcinoma (73%) the most common neoplasm (lung ACA the most common primary source). The most common benign entity is a hyperplastic lymph node (24%). Ancillary studies (immunoctyochemistry, fluorescence in situ hybridization and electron microscopy) were helpful and provided definitive diagnosis in 30% of the initially nondiagnostic FNA samples.

Full Text

Duke Authors

Cited Authors

  • Barnett, BP; Sheth, S; Ali, SZ

Published Date

  • November 2009

Published In

Volume / Issue

  • 53 / 6

Start / End Page

  • 672 - 678

PubMed ID

  • 20014557

Pubmed Central ID

  • 20014557

International Standard Serial Number (ISSN)

  • 0001-5547

Digital Object Identifier (DOI)

  • 10.1159/000325409

Language

  • eng

Conference Location

  • Switzerland