Determining the Role of Aspiration Cytology in Splenic Lesions

Background: Splenic fine needle aspiration cytology (FNAC) has been used as a diagnostic method since the turn of last century, with the first report being in 1916. It has the reputation of being dangerous & difficult to assess, but these prejudicial ideas are fundamentally wrong. FNAC remains the easy, cheap, safe and first mainstay diagnostic investigation.

Objective: The objective of the present study was to evaluate and determining the diagnostic role of aspiration cytology in splenic lesions.

Methods: Fine needle aspiration cytology (FNAC) of the spleen was performed in 34 cases in our retrospective analysis, with 28 cases aspirated under ultrasonological guidance and 6 cases aspirated blindly. There were 23 male and 11 female patients, ranging in age from 2 to 69 years, with 8 paediatric patients. All essential precautions and tests, including a coagulation profile, were carried out prior to the procedure.

Results: Five of the 34 FNAC cases had bloody aspirates, while the other two had normal splenic aspirates. In 27 of the cases, a definitive diagnosis was possible. The most patients (8 cases) in the non-neoplastic group had extramedullary hematopoiesis, followed by 4 cases of tuberculosis, 3 cases each of kala azar and storage disease, and 2 cases with granulomas. We had two cases of non-Hodgkins lymphoma, one case of Hodgkin lymphoma, two cases of hairy cell leukaemia, and one case of histiocytosis in the neoplastic group. When aspiration was performed blindly or with ultrasound guidance, no significant differences in cellularity were observed. In our research, no procedural problems were discovered.

Conclusion: As a result, when carried out with extreme caution, as a primary inquiry, FNAC spleen is a safe, low-cost, quick, and highly diagnostic treatment.