The value of Chiba fine-needle aspiration biopsy in the diagnosis of hepatic malignancy: a comparison with Menghini needle biopsy.
The detection or exclusion of metastatic liver involvement is critical in the management and prognosis of patients with malignant disease. Noninvasive imaging modalities such as computed tomography, ultrasound, and technetium colloid liver scan are highly sensitive but nonspecific. Serum alkaline phosphatase is of similar value. A blind liver biopsy by the Menghini technique is often done to confirm the diagnosis, but its yield is low. We prospectively evaluated 74 patients using blind Menghini needle biopsy and concurrent Chiba fine-needle aspiration biopsy (FNAB) techniques. A positive diagnosis of malignancy was made in 30 patients (41%). In only 25 (34%) was the diagnosis made by Menghini biopsy, while Chiba FNAB confirmed the diagnosis in all 30 patients. Thus, concurrent use of both needles increased the diagnostic accuracy by 7%. Seven additional patients, considered to have one or more contraindications for the Menghini biopsy, underwent Chiba FNAB alone; the diagnosis was confirmed in all without complication. We conclude that FNAB alone or in combination with Menghini biopsy is valuable and safe in the diagnosis of metastatic liver disease.
Farnum
J B
JB
Department of Pathology, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City.
Patel
P H
PH
Thomas
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation*; D004869:Equipment Safety; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies