Evaluation of ultrasound guided fine needle aspiration cytology in diagnosis of space occupying lesions of liver

ABSTRACT

From March 1992 to February 1995, Two hundrad and three [203] cases of space occupying lesions of liver were aspirated under ultrasound guidance. These aspirates were mostly done by senior radiology staff at Sheikh Zayed Hospital, Lahore. The smears and cell blocks when available, were studied by consultant pathologists. Based on histological, cytological and clinical findings, final diagnosis was reached. In 2.5% cases the material aspirated was reported as inadequate. Among the benign aspirates, liver abscess was the most common lesion diagnosed in 26 [59.1%] cases. Age changes with mild dysplasia and fatty change were other two common benign diagnostic features. In malignant aspirate, metastatic adenocarcinoma was tlie most common diagnosis seen in 77 [50%] cases and primary hepatocellular carcinoma was diagnosed in 58 [37.6%] cases. In cases where cell blocks were available, validity of cytological diagnosis showed high degree of sensitivity and specificity with no false positive reports. Overall results indicate high prevalence of infections, liver disease and primary hepatocellular carcinoma in our study group as compared to results in other parts of the world. Value of ultrasound guided aspiration, importance of coagulation screening and usefulness of the microhistology [cell block preparations] is stressed. The cytological features of primary hepatocellular carcinoma, and of metastatic lesions are described