Fine-needle aspiration cytology of focal liver lesions. Advantages and limitations.
Fine-needle aspiration cytology of focal liver lesions was performed 192 times in 175 patients over a 5-year period. Ultrasonic guidance was used for 153 punctures; the others were done peroperatively or on a palpable mass. A correct diagnosis of malignancy was obtained in 89/111 cases (80.2%), and of metastases (adenocarcinoma) to the liver in 71/84 (84.5%). The total of nonrepresentative aspirates was 26 (13.5%). The overall accuracy of cytologic evaluation was 87.5%, with 79.5% sensitivity and 100% specificity in malignant disease. The predictive values of positive and negative results were, respectively, 100% and 75.8%. There were no false positive tests, but 12.5% false negatives. No complications following the aspiration procedure were seen. Fine-needle aspiration biopsy is simple and safe, but the relatively high proportion of nonrepresentative aspirates is a problem. Possibly a more aggressive approach with multiple punctures may lessen this incidence and enhance the diagnostic accuracy in hepatic malignancy.
Servoll
E
E
Department of Surgery, Haukeland University Hospital, Bergen, Norway.
Viste
A
A
Skaarland
E
E
Larssen
T B
TB
Pedersen
O M
OM
Arnesjø
B
B
Søreide
O
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged