Fine needle aspiration cytodiagnosis of liver tumors - Results obtained with Riu's stain

OBJECTIVE: To present our experience with liver fine needle aspiration (FNA ) diagnosis based on Riu's stain. STUDY DESIGN: We reviewed a total of 322 liver fine needle aspirates from 2 86 patients seen in a seven-year period from April 1990 to April 1997 at Ko o Foundation Sun Yat-Sen Cancer Center, Taipei. Surgical and/or clinical fo llow-up was available for confirmation in 292 aspirates. RESULTS: The cytologic diagnosis was categorized into four groups: benign i n 81 cases, suspicious in 13, malignant in 225, and inadequate specimen in 3 cases. There were 16 false negative and no false positive diagnoses. Two suspicious aspirates were negative. Our results showed a sensitivity of 93. 3% and a specificity of 100% for the detection of malignancy. If suspicious cases were considered positive, the specificity decreased to 95.1%, while the sensitivity increased to 93.6%. Among 87 hepatocellular carcinomas (HCC s) in our series, correct FNA diagnosis was made in 84 cases with an accura cy of 96.6%. Out of 135 cases of non-HCCs, 1 was incorrectly diagnosed. The accuracy of identifying a liver malignancy as non-HCC was 99.3%. CONCLUSION: Cytologic features of HCC are well demonstrated by Riu's stain, with high accuracy in identifying them. Liver FNAs using Riu's stain combi ned with cell block study and clinicopathologic correlation can achieve ver y high sensitivity and specificity in the detection of hepatic malignancies .