Comparison between EUS-FNAC Results and Final Histopathology Results for Diagnosing Intra-Abdominal Lesions

Open Access

Abstract

Background: Intra-abdominal lesions, including pancreatic, hepatobiliary, gastrointestinal, and lymph nodal masses, pose a diagnostic challenge because imaging alone cannot reliably distinguish benign from malignant disease. Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNAC) permits real-time, minimally invasive sampling of otherwise inaccessible lesions, yet its performance against final histopathology in a South Asian tertiary-care setting remains insufficiently documented. Objective: To compare the diagnostic accuracy of EUS-FNAC with final histopathological examination in patients with intra-abdominal lesions. Methods & Materials: This observational analytical study was conducted in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January 2016 to February 2017. Twenty-five patients with intra-abdominal lesions underwent EUS-FNAC, and findings were compared with final histopathology, the reference standard. Sensitivity, specificity, predictive values, and diagnostic accuracy were calculated, and complications recorded. Results: The mean age was 50.04 ± 18.89 years, and 68.0% were male. Pancreatic lesions were commonest (64.0%). FNAC identified malignancy in 72.0% of cases, while histopathology confirmed malignancy in 84.0%. Among 24 evaluable patients, EUS-FNAC showed a sensitivity of 90.0%, specificity of 100.0%, positive predictive value of 100.0%, negative predictive value of 66.67%, and diagnostic accuracy of 91.67%. Complications occurred in 28.0% of patients, all minor, most commonly abdominal pain (20.0%), with no factor significantly associated with their occurrence. Conclusion: EUS-FNAC demonstrates high sensitivity, specificity, and diagnostic accuracy for intra-abdominal lesions against final histopathology, with an acceptable and predominantly minor complication profile, supporting its role as a reliable first-line tissue-sampling modality.