Criteria for diagnosis of hepatocellular carcinoma and metastatic liver disease by fine needle aspiration biopsy

ABSTRACT

Fine needle aspiration biopsy [FNAB] of masses in the liver is gaining wide use. In this study we examined 32 FNAB smears [sonar guided] followed by liver biopsy in order to identify helpful criteria for diagnosis of primary and metastatic liver tumours. FNAB confirmed the diagnosis in 22 out of 28 patients with hepatocellular carcinoma [HCC] with diagnostic accuracy of 78.57 percent, and 4 metastatic adenocarcinoma with accuracy of 100 percent. The diagnosis was made by cytologic examination of the FNAB smear and confirmed by histopathologic examination of liver biopsy. For diagnosis of HCC we recommend the criteria of Cohen et al., 1991 that applied very well to all cases. The diagnosis of metastases was based on the exclusion of the criteria for HCC, the absence of atypical naked nuclei, presence of 2 cell populations and the presence of normal hepatocytes. FNAB proved to be a reliable method for evaluation of mass lesions in the liver