Ultrasound-guided fine-needle aspiration cytology of hepatic mass - A minimally invasive diagnostic approach

ABSTRACT

Background: Ultrasound-guided fine-needle aspiration (FNA) is a safe, simple, accurate, rapid, and an effective method for approaching a hepatic lesion. Objectives: The objectives of this study were as follows (1) To assess the utility of ultrasound-guided FNA cytology (FNAC) in the diagnosis of hepatic mass, (2) to categorize hepatic masses into benign and malignant lesions to assess the nature of mass, and (3) to study the cytomorphological features of various liver lesions. Materials and Methods: The study was conducted in the department of pathology between January 2014 and April 2016. Ultrasound-guided FNAC was performed on 62 patients with hepatic mass lesions. The patients with hemangioma and hydatid disease of the liver diagnosed by ultrasonography were excluded to prevent undue complications. Results: There were 39 (62.9%) males and 23 (37.09%) females with a mean age of 52.5 years ranging from 10 to 85 years. Samples were adequate in 57 (93.5%) and inadequate in 5 (6.5%). Of 57 adequate samples, five show inflammation, two were benign, and 50 were malignant. Of the inflammatory lesions, pyogenic liver abscesses in 3 (5.26%) and amoebic liver abscesses in 2 (3.51%). Benign lesion included hepatic adenoma in 2 (3.51%). Of the malignant lesions, metastatic adenocarcinomas was in 22 (38.60%), hepatocellular carcinomas was in 10 (17.54%), metastatic deposits of poorly differentiated carcinoma was in 10 (17.54%), metastatic squamous cell carcinoma was in 5 (8.78%), hepatoblastoma was in 2 (3.51%), and cholangiocarcinoma was in 1 (1.75%) case. All the hepatocellular carcinomas in our study occurred in males (4 of 4). Conclusion: Ultrasound-guided FNAC of the liver has a significant role in diagnosis of palpable and non-palpable hepatic mass. It is a rapid, highly accurate, safe, and cost-effective diagnostic method which avoids invasive diagnostic procedures.