Laparoscopic aspiration of ovarian cysts: an unreliable technique in primary diagnosis of (sonographically) benign ovarian lesions

Objective

To assess the value and limitations of aspiration cytology in the diagnosis of cystic lesions of the ovary which were predicted sonographically as benign.

Design

A prospective study. All patients, pre- and postmenopausal, who were going to have a laparoscopic cystectomy or oöphorectomy had a laparoscopic aspiration of the cyst. Without knowledge of the patient's clinical history or the histology of the lesion, cytological evaluation was performed. Cytomorphological evaluation and prediction of the subsequent histological diagnosis was made.

Results

Between July 1994 and August 1996 60 aspirates were evaluated. Of the aspirates, 16 (27%) were not evaluable, according to our cytological criteria. The predictive value for discrimination between functional or neoplastic cysts was 65% (95% CI, 52–77%). Sensitivity and specificity were 91% (95% CI, 80–97%) and 67% (95% CI, 22–96%), respectively. The predictive value for the correct histological diagnosis was 42% (95% CI, 29–55%). The size of the cyst had no significant predictive value for the histological diagnosis.

Conclusion

Cytological evaluation of aspirates of ultrasonographically benign ovarian cysts gives no additional information regarding the histology of the lesion. Because the therapeutic significance of this method is also low, aspiration of ovarian cysts should be abandoned.