Histological and cytological fine needle biopsies from focal liver lesions. Intra- and interobserver reproducibility of diagnoses.
In 175 consecutive cases of ultrasonically detected focal liver lesions both cytological (CFNB) and histological (HFNB) fine needle biopsies were performed with two different 0.6 mm needles and evaluated twice and blindly by two examiners. The intra- and interobserver kappa values for reproducibility concerning a malignant diagnosis were higher for CFNB (0.94-0.96) than for HFNB (0.89-0.93). At re-evaluation most inconsistent diagnoses could be related to biopsies of poor quality (CFNB 4 cases, HFNB 13 cases). In three cases (CFNB 2, HFNB 1) false interpretation of the biopsies could have been the cause of inconsistent diagnoses. CFNB resulted in significantly more consistent, malignant diagnoses than HFNB, and CFNB is therefore recommended as the method of choice in cases of a known primary tumour. A morphological diagnosis of a breast carcinoma and of a colonic carcinoma as the primary tumour was better reproduced by HFNB than by CFNB. A diagnosis of a primary liver tumour and of a small cell carcinoma of the lung had a reasonable reproducibility with both methods (kappas greater than 0.60). Other diagnoses were poorly reproduced or occurred infrequently. Both methods are recommended for use in cases of an unknown primary tumour.
Glenthøj
A
A
Department of Pathology, Herlev University Hospital, Denmark.
Sehested
M
M
D001707:Biopsy, Needle / Q000592:standards*; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary