FINE-NEEDLE CYTOLOGICAL DIAGNOSIS OF FOCA L HEPATIC-LESIONS

Background: Image guided fine needle cytological diagnosis of hepatic lesions has become a routine diagnostic procedure. Aim: To analyze the diagnostic yield of fine needle cytological aspirates of the liver. P atients and methods: Two hundred two aspirates, obtained in 201 patien ts were studied. Procedures were performed under ultrasound guidance i n 77.9% of cases and under CT scan guidance in 22.1%. Cytological diag nosis was compared with definitive pathological diagnosis in 136 patie nts and with clinical follow up in 66. Results: Cytology was positive for malignant cells in 81.2% of cases, negative for malignant cells in 15.3%, inconclusive in 1% and the sample was inadequate in 2.5%. Cyto logy was false negative for malignant lesions in 17 cases and there we re no false positives. It had a sensitivity of 90.6%, a specificity of 100%, a positive predictive value of 100% and a negative predictive v alue of 55.3%. The histological types of malignant lesions were adenoc arcinoma in 48.2% of cases, hepatocellular carcinoma in 16.5% and non specified carcinoma in 20.7%. The main sites of the primary tumors wer e the liver in 24.4% of cases, gallbladder and biliary tract in 20.9%, intestine in 15.1%. Conclusions: Cytological diagnosis of fine needle aspirates of the liver obtained under image guidance are a valuable s upport in the diagnosis of focal liver lesions.