title: Fine-needle biopsy in focal liver lesions: the usefulness of a screening programme and the role of cytology and microhistology.
abstract: We evaluated the diagnostic usefulness of 244 ultrasound-guided fine-needle biopsies (FNB) in 226 patients with suspected liver malignancies. A malignancy was detected in 166 cases (73%) -145 hepatocellular carcinomas (HCC), 21 metastases; benign lesions were aspirated in 60 cases (27%). The sensitivity of FNB was 93%, with 100% specificity. In the FNB false-negative cirrhotic nodules, a final diagnosis of HCC was reached on repeating the biopsy 1-8 months later. When both cytological and microhistological examinations were performed, the positive correlation between the two techniques was 80%, with a slightly higher sensitivity for microhistology (93%). The malignancies diagnosed were potentially resectable in 26% of cases. We experienced 1 acute complication of FNB and 1 case of needle tract tumour seeding. These results confirm that FNB is useful in diagnosing malignant liver tumours. We believe that US-guided FNB is the first-choice invasive technique for assessing focal benign lesions and malignant tumors in the liver.
authors.affiliation: Cattedra Malattie Apparato Digerente, Istituto di Medicina Interna, Universita di Padova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Herszenyi
authors.forename: F
authors.initials: F
authors.lastname: Farinati
authors.forename: A
authors.initials: A
authors.lastname: Cecchetto
authors.forename: C
authors.initials: C
authors.lastname: Marafin
authors.forename: N
authors.initials: N
authors.lastname: de Maria
authors.forename: R
authors.initials: R
authors.lastname: Cardin
authors.forename: R
authors.initials: R
authors.lastname: Naccarato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009366:Neoplasm Seeding; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography