Ultrasonically guided percutaneous fine-needle aspiration biopsy of hepatic focal lesions

ABSTRACT

Ultrasonically guided percutaneous fine-needle aspiration biopsies of the liver were performed on 215 patients with a clinical and sonographic suggestion of hepatic malignancy. Several aspirations at the suspected areas were made in each case. The aspirate cytology was positive for malignancy in 161 cases [hepatocellular carcinoma 98 cases, anaplastic carcinoma 12, angiosarcoma 9 and metastatic carcinoma 42]. There were no false positive results. 145 cases with malignancy were diagnosed on the initial aspirate and among the negative cases, 16 showed evidence of malignancy on repeated aspiration [false negative in 9.9 percent, dropped to zero level on re-aspiration]. Aspirate cytology in the non-malignant focal areas revealed haemangioma in 9 cases, echogenic liver abscesses, focal fatty degeneration 15, regenerative nodules in 22 cases. The puncture and aspirate of these 215 cases did not reveal any immediate compactions. Multiple fine-needle aspirate cytology of hepatic focal areas under ultrasonic guidance are of great diagnostic value with high accuracy in detecting hepatic malignancy