Background and Objectives. Thoracic lesions account for various benign and malignant conditions. Of these lung carcinoma (mainly primary) is the most common carcinoma in the world. The present study was undertaken to know the pathological spectrum of thoracic lesions and to correlate cytoradiological findings. Materials and Methods. The present study was conducted in a tertiary care center of North India on 74 patients over an 18-month period. CT guided transthoracic FNAC (TTFNA) was carried out, and aspirates were drawn, examined, and compared with radiological diagnoses. Results. The diagnostic accuracy for FNA in the present study was calculated to be 95.94% (using cytology as the gold standard). The predominant lesion was malignancy (85.1%), followed by suspicions of malignancy and inflammatory pathology (5.40% each). By cytology, the most common malignant lesion was adenocarcinoma (48%) followed by squamous cell carcinoma (40%), small cell carcinoma (8%), and undifferentiated carcinoma (4%). Cytoradiological correlation was found to be 89.2% in the present study. Conclusion. Present study thus concludes that TT FNA of thoracic lesions is a simple, safe, economically prudent technique associated with low morbidity and leading to quick and early diagnosis. 1. Introduction Thoracic lesions include a large variety of benign and malignant conditions of lung, pleura, mediastinum, and vertebrae. Primary lung carcinoma is the most common carcinoma in the world today, comprising 12.6% of all the cancers and 17.8% of all the cancer deaths [1]. Lung is also a well-known site for metastatic tumors. In addition, the mediastinum can be involved with a variety of benign lesions as well as by primary and metastatic malignant tumor, many of which present as mediastinal masses [2, 3]. Although clinical data, location, and radiological findings can narrow down the diagnostic possibilities, cytological diagnosis is warranted before initiating the specific treatment for malignant diseases [4]. Percutaneous CT-guided transthoracic fine needle aspiration cytology (TTFNA) is a well-established diagnostic method used in cytological evaluation of thoracic mass lesions. Currently TTFNA for lesions of the lungs and mediastinum is a widely practiced method, where the facilities of standard imaging techniques and cytopathology are available. This procedure provides a safe, rapid, and accurate diagnosis in patients having thoracic mass lesions [3–5]. In patients with lung cancer which is inoperable owing to local factors or the patient’s general condition, FNAC confirms the
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