ABSTRACT
Liver is the most common site of distant metastases. Vast majority of malignant tumours in liver are metastatic most commonly adenocarcinoma from colon, pancreas, breast and lung. Combined cytological and histological preparation via one - shot fine needle aspiration can be evaluated, especially in outpatients. Technique could guide management in the setting of equivocal imaging and serology. Study was carried out on 64 patients admitted to the gastrointestinal ward of Sheikh Zayed Hospital Lahore with space occupying lesion [SOL]. Lesions were aspirated under ultrasound guidance using 18 - guage lumber puncture needle. The aspirate was used for histology and slides for cytological examination. It is observed that on the basis of cytological examination 11 cases were confirmed as benign and 52 as malignant whereas on histological basis 08 cases were confirmed as benign and 50 as malignant. Diagnosis on cytology showed 27 cases of metastatic adenocarcinoma, 11 case of melanoma, dysphasia, and sarcoma [08]. The cytology could provide correct diagnosis is 80.8%. The sensitivity specificity, positive value, and negative predictive value, were 96.3%, 100%, 100%, 84.6% respectively. On histology, a final diagnosis on haemotoxylin and eosin [H and E] stained slides could be reached in 52 out of 54 malignant lesions. Of these 54 metastatic lesions, 37 were adenocarcinomas. Eight were malignant melanoma, 7 were metastatic spindle cell carcinoma and 2 were unclassified malignant tumours. It was concluded that aspiration cytology is quite accurate in detecting and classifying malignancy as compared to histological techniques. However combined cytology and histology increases the diagnostic sensitivity