VALUES OF FINE-NEEDLE ASPIRATION BIOPSY OF THE LIVER UNDER ULTRASONIC GUIDANCE IN COMBINATION WITH CYTOLOGY AND HISTOLOGY IN DIAGNOSIS OF HEPATIC NEOPLASMS

Abstract

Percutaneous aspiration biopsy of the liver using a heparinized fine 22-gauge needle was performed under ultrasonic guidance in 14 patients with benign hepatic disease and 26 patients with hepatic malignancy. When a heparinized needle and syringe were used, it was possible to centrifuge the aspirated materials obtained and make good smears containing abundant tumor cells. Heparinization also made it possible to recover small tissue fragments from the needle and make ultrathin sections for histological examination by a routine procedure for electron microscopy.
In this way, materials suitable for cytological examination could be obtained from all patients with hepatic malignancy, and a correct diagnosis was made cytologically 24 (92.3%) of 26 patients with malignant hepatic neoplasm. Histological specimens were obtained from 22 (84.6%) of 26 patient with hepatic malignancy. A correct diagnosis was made in 20 (90.0%) of 22 patients with hepatic neoplasm from which histological materials were obtained. From a combination of histological and cytological results, the overall diagnostic rate for hepatic malignancy increased to 96.2%. These was no relation between the location and size or echo pattern of the tumors and the overall accuracy. By this method, a correct diagnosis could be made in a patient with a small hepatocellular carcinoma of 0.8cm in longest diameter. Therefore, this procedure is a reliable method for diagnosis of hepatic malignancy.