Cytologic diagnosis of ovarian tumors: Factors influencing accuracy in previously undiagnosed cases

OBJECTIVES: Cytologic diagnosis of ovarian masses by needle aspiration techniques remains controversial. This reviw proposes to define the accuracy of the technique, report complications, and relate clinical situations in which the technique was used. STUDY DESIGN: In a retrospective review all patients undergoing cytologic aspiration biopsy diagnosis of ovarian masses at the University of Virginia Health Sciences Center from 1986 through 1993 were identified, and 74 women with corresponding histologic material were used. Clinical data were abstracted and all cytologic and pathologic material was reviewed. RESULTS: The overall sensitivity of the 74 aspiration biopsies to predict the histologic diagnosis of malignancy was 78%; specificity was 92%. Two patients had complications, one necessitating operative intervention. Correct diagnoses were influenced by menopausal status, patient age, sample type, aspiration method, and cytologic quality. CONCLUSIONS: The cytologic diagnoses of ovarian tumors, while quite specific, lack the sensitivity for general application. Use of this diagnostic technique must remain individualized, and the factors that influence the accuracy of the technique must be kept in mind. There remains the need for standardization of reporting fine needle aspiration results.