Diagnostic Accuracy of Percutaneous Cytodiagnosis of Hepatic Masses, by Ultrasound Guided Fine Needle Aspiration Cytology

Abstract

Objective: To evaluate the diagnostic accuracy, usefulness and limitations of ultrasound guided FNAC of hepatic masses.
Design: Cross – sectional analytical (comparative study).
Place and Duration: Department of histopathology, Sheikh Zayed Hospital, Lahore. Study period 1 year.
Material and Methods: A total of 32 patients with solitary or multiple hepatic masses underwent FNAC from March 1999 to March 2000. Adequate aspirates were obtained in all these cases. Smears were stained with May-Grunwald Giemsa, Hae-matoxylin and Eosin and Papanicolaou stain. Needle biopsies from the same cases were also obtained and processed. These were stained with routine Haematoxylin and Eosin staining. The blood clots obtained during FNAC were fixed in 10% neu-tral buffered formalin. The histopathology of these blood clots was used for cases whose needle core biopsy was not avai-lable. The screened FNAC smears were divided into 3 categories i.e., benign (group – I), malignant (group – II), non-neoplastic / inflammatory lesions (including cysts and abscesses) (group – III).
Results: Out of 32 cases, 6 were categorized as benign, 18 as malignant, and 8 as non-neoplastic inflammatory lesions. Three false negative diagnoses, including 1 for malignant tumour and 2 for benign tumours was obtained. There was 1 false positive diagnosis for malignancy. FNAC – histological correlation showed a 94.2% sensitivity and 92.3% diagnostic accu-racy for malignant tumours, while benign tumours posed maximum diagnostic problems, giving a 66.67% sensitivity and 85.7% diagnostic accuracy. FNAC picked up correctly all the non-neoplastic lesions giving a 100% sensitivity and diagnostic accuracy.
Conclusion: Majority of the malignant tumours can be categorized on FNAC, with a high degree of accuracy, while benign tumours should be subjected to biopsy, as there is a relatively greater possibility of false negative diagnosis.
Key words: FNAC, benign, malignant, non-neoplastic.