A Prospective Study of Ultrasound Guided Fine Needle Aspiration Cytology of Focal Lesions in Liver

Introduction: Many hepatic lesions which are detected clinically or by imaging technique are easily accessible to Fine Needle Aspiration Cytology (FNAC). Swift diagnosis by FNAC helps to save precious time and allow clinicians to duly plan treatment. Ultrasound guided FNAC of the liver is a safe, cheap, relatively non-invasive procedure with minimum complication and can be routinely done for evaluation of liver diseases. Aim: To evaluate hepatic lesions by ultrasound guided FNAC and classifying into inflammatory or non-inflammatory, benign or malignant, primary or secondary tumour and also to find novel cytological features. Materials and Methods: The present two-year descriptive crosssectional prospective study was carried out in the Department of Pathology, Karnataka Institute of Medical Sciences, Hubli. A total of 90 patients who satisfied the inclusion criteria during the two years study (August 2012 to July 2014) were assessed for clinical history and subjected to FNAC under ultrasound guidance. Descriptive statistical analysis was performed to calculate the percentage and frequency for the categorical variable included in the study. Results: Out of 90 cases, majority 73 cases (81.1%) were neoplastic and 11 cases (12.2%) were non-neoplastic and the remaining 6 cases (6.6 %) were inconclusive. Out of 73 cases, 4 cases were benign tumours and 69 cases were malignant tumours. Out of 69 cases, 32 cases were Hepatocellular Carcinoma (HCC), 32 cases were metastatic deposits, 3 cases were cholangiocarcinoma, one case was suggestive of malignancy. Among 33 cases of metastatic deposits, adenocarcinoma was most common (32 cases) and squamous cell carcinoma the least (1 case). The most consistent cytological findings in HCC were macronucleoli (32 cases) and trabecular pattern of arrangement (32 cases). The most consistent finding in metastatic adenocarcinoma was coarse clumping of nuclear chromatin (32 cases). Conclusion: The study concludes that the ultrasoundguided FNAC of the liver is a safe, simple, cost-effective, and accurate method that permits the categorisation of non-neoplastic (inflammatory) and neoplastic lesions (noninflammatory), primary and secondary malignancy in a simple and rational manner which is helpful for the management of hepatic lesions.

Abstract licence: CC BY-NC-ND

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