ULTRASONICALLY-GUIDED NEEDLE ASPIRATION WITH PREPARATION OF CELL BLOCKS IN THE DIAGNOSIS OF LIVER-TUMORS

To evaluate the diagnostic value of a method combining ultrasonically- guide Chiba needle aspiration and histological block preparation of as piration specimen, 50 consecutive patients with histologically confirm ed focal or diffuse lesion of the liver were studied. In addition to c onventional aspiration cytology, the aspiration specimen was mixed 1:1 by volume with 95% alcohol and centrifuged. The precipitated specimen was then embedded in paraplast. Serial sections were obtained and sta ined with hematoxylin and eosin (H and E) technique. The diagnostic sp ecificity and positive predictive value of the cell block technique in diagnosing hepatic malignancies were both 100%, as was those of aspir ation cytology. The diagnostic sensitivity and overall accuracy of cel l blocks were significantly better than those of aspiration cytology ( 89.5% vs. 63.2%, P < 0.01; and 92.0% vs. 72.0%, P < 0.01). The negativ e predictive value of cell blocks was also better than that of aspirat ion cytology, but the difference was not statistically significant (75 .0% vs. 46.2%, P > 0.05). In terms of cellular differentiation, the ac curacy of the diagnosis of cell blocks was 78.6% (22/28) in hepatoma; 80.0% (4/5) in metastatic adenocarcinoma and 100.0% (1/1) in small cel l carcinoma. No complications were encountered in any of the patients. The results suggest that the preparation of cell blocks of the aspira tion specimen is a reliable and accurate method for the diagnosis of h epatic malignancies. This method also elevates the diagnosis of the as piration specimen from the cytological to the histopathological level.