Ultrasound-guided fine needle aspiration biopsy in differential diagnosis of portal vein tumor thrombosis.
BACKGROUND
Portal vein tumor thrombosis (PVTT) is a serious complication and a major metastatic way of hepatocellular carcinoma(HCC). But portal vein benign thrombosis(PVBT) always appears in patients with hepatocirrhosis, and PVTT should be differentiated from PVBT. The aim of this study was to probe the value of ultrasound-guided fine needle aspiration biopsy in differential diagnosis of PVTT.


METHODS
Twenty-two HCC patients with portal vein thrombosis and 8 hepatocirrhosis patients with portal vein thrombosis were studied by ultrasound-guided fine needle aspiration biopsy. Twelve portal vein thrombosis filling portal vein embranchment of the 30 portal vein thrombosis patients were examined by 18G automatic biopsy. The positive rates of aspiration biopsy cytology and histology were calculated and compared with those of automatic biopsy.


RESULTS
The positive rates of fine needle aspiration biopsy cytology and histology were 93.3% (28/30) and 90.0% (27/30), respectively. They were not different markedly from that of automatic biopsy 91.7% (11/12). In aspiration biopsy of 22 HCC patients with PVTT, HCC cellular was found in 19 portal vein thrombosis patients (86.4%) by cytology examination and in 18 portal vein thrombosis patients (81.8%) by histology examination. In total, 20 tumor thrombi were detected. The other two were diagnosed as benign thrombosis. No HCC cell and/or tissue was observed in 8 patients with hepatocirrhosis associated with portal vein thrombosis.


CONCLUSIONS
Ultrasound-guided fine needle biopsy in detecting PVTT shows a high positive rate and is of diagnostic value. The positive rate is not apparently different from that of automatic biopsy. Hence the case that fails to be diagnosed by color Doppler flow imaging(CDFI) and pulsed Doppler can be detected early by ultrasound-guided fine needle aspiration biopsy.
Yang
Long
L
Department of Ultrasound, Union Hospital, Fujian Medical University, Fuzhou 350001, China. yl3846652@sina.com
Lin
Li-Wu
LW
Lin
Xue-Ying
XY
Gao
Shang-Da
SD
He
Yi-Mi
YM
Yang
Fa-Duan
FD
Xue
En-Sheng
ES
Lin
Xiao-Dong
XD
D001707:Biopsy, Needle / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011169:Portal Vein; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000473:pathology*