Advertisment MEACR
Home Print this page Email this page Users Online: 149
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2013  |  Volume : 2  |  Issue : 2  |  Page : 132-142

Fine-needle aspiration cytology and biopsy in hepatic masses: A minimally invasive diagnostic approach


1 Department of Pathology, Pandit Deendayal Upadhyay Government Medical College and Hospital, Rajkot, India
2 Department of Pathology, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
3 Department of Pathology, The Gujarat Cancer and Research Institute, Ahmedabad, India
4 Department of Preventive and Social Medicine, Shree Meghji Pethraj Shah Medical College, Jamnagar, Gujarat, India

Correspondence Address:
Jitendra G Nasit
C/4, Suryadeep Society, Near Nutan School, Behind Chanakyapuri Society, New Sama Road, Vadodara - 390 008, Gujarat
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-0513.113636

Rights and Permissions

Aims and Objective: To evaluate the diagnostic sensitivity, usefulness and limitations of fine-needle aspiration cytology (FNAC) and fine-needle aspiration biopsy (FNAB) in the diagnosis of hepatic masses. Materials and Methods: FNAC was performed on 150 cases of hepatic masses under guidance of ultrasound or computed tomography (CT) scan. Adequate diagnostic aspirates were obtained in 147 cases (98.0%). Smears were stained with hematoxylin and eosin (H and E), and Papanicolaou stains. FNAB was obtained from the same 149 cases (except one) and stained with HE stain. The hepatic masses were categorized into benign, malignant and inflammatory groups. Results: Out of 150 hepatic masses, 3.3% were benign, 94.26% were malignant and 2% were inflammatory lesions. FNAC and FNAB were unsatisfactory for evaluation in 3 out of the 150 cases (2%) and 6 out of 149 cases (4.02%), respectively. Correct cytological diagnoses were achieved in 129 out of the 150 cases (diagnostic sensitivity: 86%). FNAB gave satisfactory results in 143 out of 149 cases (diagnostic sensitivity: 95.77%). Cytological diagnoses of 21 cases were not consistent with histology (false negativity: 14%). Cyto-histological correlation showed 87.32% diagnostic sensitivity of FNAC for malignant tumors, whereas benign tumors posed maximum diagnostic problems, with sensitivity of 40%. This difference was statistically significant (P < 0.05). FNAB showed a statistically significant difference (P < 0.05) compared with FNAC in the diagnosis of benign and malignant hepatic masses. FNAC showed 100% diagnostic sensitivity for inflammatory lesions. Conclusion: Malignant tumors of liver can be confidently diagnosed on FNAC. However, FNAC has a few limitations and diagnostic challenges in benign lesions, well-differentiated and poorly differentiated hepatocellular carcinoma, and metastatic carcinoma. Microhistology by FNAB allows architectural, cellular and immunohistochemical evaluation. To obtain maximum diagnostic information with reduction of indeterminate reports, a combined approach of FNAC and FNAB with clinical findings, tumor markers and ancillary techniques should be used.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed7115    
    Printed66    
    Emailed2    
    PDF Downloaded191    
    Comments [Add]    
    Cited by others 1    

Recommend this journal