ASPIRATION CYTOLOGY OF LIVER-ABSCESSES - WITH AN EMPHASIS ON DIAGNOSTIC PITFALLS

Clinical and imaging features of liver abscesses are not specific. Nec rotic hepatic neoplasms, primary or secondary, can mimic abscesses, an d vice versa. Thirty-eight patients who had cytologic examinations for suspected abscesses or who had cytologically confirmed abscesses were analyzed. There was clinical, radiologic and cytologic concurrence in 27 patients. In six cases the clinically suspicious lesion turned out to be inflammatory. The remaining five were malignant. There were fou r amebic and three tuberculous cases in this series. Cytologically, py ogenic abscesses contained a heavy, neutrophilic, inflammatory exudate with nuclear debris. By comparison, amebic cases contained more necro tic debris, with degenerating hepatocytes and fewer inflammatory cells . Acid-fast bacilli were identified in two tuberculous abscesses; howe ver, only one contained caseous necrotic material and epithelioid cell s. A potential pitfall in the cytologic diagnosis of a case of inflamm atory pseudotumor is emphasized. The diagnosis of liver abscess should be established by clinical and imaging findings in conjunction with n eedle aspiration.