Fine needle aspiration of the liver.
A total of 81 transhepatic fine needle aspiration (FNA) biopsies were performed on 78 patients to rule out focal or diffuse neoplastic disease; 87.6% were performed with ultrasound guidance, 6.1% with CT guidance, 3.7% intraoperatively and 1 using fluoroscopy during percutaneous transhepatic cholangiography. Smears of the aspirated samples were cytologically evaluated with clinical and radiologic correlation; in addition, histologic examination of cell blocks was performed in 46% of the cases, ultrastructural examination in 34% of the cases and peroxidase-antiperoxidase staining in 3 cases. Ultrastructural definition of the type of malignancy was possible in 24 cases (29%). Minor complications in two patients were pain and tenderness at the puncture site. The sensitivity for malignancy was 91%, the specificity was 100%, the predictive value of positive results was 100%, and the predictive value of negative results was 73%. This series demonstrates that FNA biopsy with ultrasound guidance can provide an accurate diagnosis of malignancy and may preempt a lengthy workup in the search for a primary tumor.
Pinto
M M
MM
Department of Pathology, Bridgeport Hospital, CT 06610.
Avila
N A
NA
Heller
C I
CI
Criscuolo
E M
EM
D000230:Adenocarcinoma / Q000473:pathology; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D003951:Diagnostic Errors; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary; D008297:Male; D008875:Middle Aged