Cytodiagnosis of focal hepatic lesions by image guided fine needle biopsy
Gallegos, M.; Cruz, F.; Quintana, M.E.; Duarte, I.
Revista Medica de Chile 125(2): 183-190
1997
ISSN/ISBN: 0034-9887 PMID: 9430938 Document Number: 471695
Image guided fine needle cytological diagnosis of hepatic lesions has become a routine diagnostic procedure. To analyze the diagnostic yield of fine needle cytological aspirates of the liver. Two hundred two aspirates, obtained in 201 patients were studied. Procedures were performed under ultrasound guidance in 77.9% of cases and under CT scan guidance in 22.1%. Cytological diagnosis was compared with definitive pathological diagnosis in 136 patients and with clinical follow up in 66. Cytology was positive for malignant cells in 81.2% of cases, negative for malignant cells in 15.3%, inconclusive in 1% and the sample was inadequate in 2.5%. Cytology was false negative for malignant lesions in 17 cases and there were no false positives. It had a sensitivity of 90.6%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 55.3%. The histological types of malignant lesions were adenocarcinoma in 48.2% of cases, hepatocellular carcinoma in 16.5% and non specified carcinoma in 20.7%. The main sites of the primary tumors were the liver in 24.4% of cases, gallbladder and biliary tract in 20.9%, intestine in 15.1%. Cytological diagnosis of fine needle aspirates of the liver obtained under image guidance are a valuable support in the diagnosis of focal liver lesions.