Safety And Usefulness Of FNAC In Hepatobiliary Tumors

Abstract

Cytological diagnosis is quite helpful in planning the management of many neoplastic disease. FNAC is routinely employed in the diagnosis of breast and thyroid disease. With ultrasonographic (USG) and computerized tomography (CT) guided FNAC, deep seated lesions are being diagnosed more accurately and frequently. A prospective study was conducted in a major teaching hospital to evaluate usefulness and safety of FNAC in hepatobiliary tumours. A total of 20 patients where hepatobiliary malignancy was suspected clinically and supported by USG or CT scan were subjected to FNAC under USG, FANA was performed with 22G needle under the guidance of USG, results were evaluated in terms of cellularity of the aspirate (good, poor and inconclusive), successful cytological diagnosis and complications of the procedure. It was successful in 10 out of those 14 cases of of lover masses. Eight had hepatocellular carcinoma, one was metastatic sarcoma and one patient had pyogenic abscess. In case of gallbladder tumors only one case could not be diagnosed because aspirate contained normal hepatic tissue only. In 5 cases diagnosis of adenocarcinoma was confirmed. Fifteen out of these 20 cases were having obstructive jaundice and a deranged coagulation profile to various extents, which was corrected prior to FNAC proceeding to the procedure where ever needed. Only 2 patients developed pain at the site of puncture, which settled with analgesics. Two patients had minor bleeding and one of them developed a small hematoma around the point of puncture. This also settled with conservative management. None of the patients has any major complication like biliary peritonitis. Overall sensitivity of the procedure was 75 percent and there was no significant complication associated with it rendering the procedure a safe and effective method of diagnosing the hepatobiliary tumors.