ULTRA SOUND GUIDED FINE NEEDLE ASPIRATION CYTOLOGY OF LIVER – FOUR YEAR STUDY (original) (raw)
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IOSR Journals , 2019
Introduction: Liver is one of the most common sites for both neoplastic and non-neoplastic lesions. Ultrasound guided FNA of liver is safe, cheap and relatively noninvasive procedure with minimum complications. Material and Methods: This study was a prospective cross sectional study over a period of one year from January 2018 to December 2018 with 50 cases and was conducted in the radiology and pathology departments of LN Medical College and JK Hospital, Bhopal. Results: Of the total 50 cases, 13 [26%] cases were Benign and 37 [74%] were malignant, or suspicious for malignancy. All the samples were satisfactory and had good diagnostic yield so there were no non-representative samples. Amongst the Benign Lesions, Liver abscess was the most common lesion with 8% cases followed by Cirrhosis [6%] and Normal liver [6%].Metastatic tumors were the most common among the malignant lesions and constituted 50% of the cases followed by Primary liver carcinoma-Hepatocellular Carcinoma [12%].Among the metastatic lesions, adenocarcinoma was the most common .Conclusion: Categorisation of liver lesions into malignant or benign can be done by Ultrasound guided FNAC with high accuracy. Guided FNAC is simple and safe and helps in distinguishing liver lesions without much difficulty than ultrasonography alone or fine needle aspiration cytology alone.
Fine-needle aspiration biopsy of hepatic lesions
Cancer, 2006
BACKGROUND. Computerized tomographic (CT)-guided fine-needle aspiration (FNA) cytology is a well-established tool in the diagnosis of hepatic lesions. Endoscopic ultrasound-guided FNA (EUS-FNA), developed recently and used predominantly in evaluating mediastinal and pancreatic lesions, provides access to a significant portion of the liver and to perihepatic structures not readily accessible by a percutaneous approach. A recent experience (1997-2002) with CT-guided FNA of liver lesions at the University of Alabama Birmingham (UAB) was compared with the first 2.5 years of EUS-FNA experience (2000)(2001)(2002). Cases were identified using a SNOMED search and all reports and cytologic slides were retrieved for review.
Evaluation of guided fine needle aspiration cytology in the diagnosis of hepatic lesions
Objectives: To categorize the lesions of liver observed on FNAC into malignant or benign, to correlate the radiological observations with cytology findings and to perform histopathological correlation wherever possible. Material and methods: A total of 150 cases underwent ultrasonography-guided FNAC, in whom lesion/pathology in the liver was suspected and hepatic mass was confirmed on radiological examination with normal prothrombin time. This study was performed on admitted and OPD patients of SRMS IMS, Bareilly from November 2014 to May 2016. Results: Of the total 150 cases, 4 liver aspirates were inadequate for cytological evaluation and were excluded. Most cases (48 cases; 32.87%) were found in the 6 th decade. Radiological findings revealed that out of 146 cases, 6(4.10%) were benign and 140(95.9%) were malignant, while cytological examination revealed 13(8.90%) as benign and 133 (90.09%) as malignant. Among malignant cases, 93.2% were metastatic, the commonest being metastatic adenocarcinoma. Correlation between radiodiagnosis and FNAC was evaluated, which revealed a significant change. Sensitivity and specificity of FNAC were 90.00% and 100% respectively. Accuracy of FNAC was observed to be 90.5% when compared with histopathology; however, the latter was available in very small number of cases. Conclusion: Categorisation of liver lesions into malignant or benign can be done on FNAC with high accuracy. Guided FNAC is very useful in diagnosis of different hepatic lesions as the procedure is simple and safe. The results are obtained quickly without serious complications related to the procedure.
Role of guided fine needle aspiration cytology in mass lesions of liver
Introduction: High incidence of liver diseases is seen in our country. Diseases of liver that present as a mass lesion can be a diagnostic dilemma. Nowadays guided fine needle aspiration cytology (FNAC) is utilized with greater frequency to identify and diagnose such lesions. The present study was carried out to investigate the profile of liver diseases presenting as a mass lesion in a primary care setting, using guided FNAC as a diagnostic tool. Amongst these patients, efficacy of FNAC in segregating a cohort that needs palliative care only – at the level of primary care medical facility-is also analysed. This would help in minimizing the economic burden of the patient and the expenditure entailed by the society; thereby allowing proper use of scarce medical facilities in resource poor countries. Methods: CT or ultrasound guided FNAC was carried out in 83 patients in a primary medical care facility. Based on cytological diagnosis, their demographic profile was analysed. Results: Primary or secondary malignancy was diagnosed in 46 patients. Metastatic carcinoma comprised the predominant group amongst neoplastic lesions of the liver. In 28 patients, diagnosis of pyogenic or amoebic abscess or hydatid cyst was made. It was possible to identify with the help of guided FNAC, a group of patients suitable for palliative care only. Conclusions: Guided FNAC is a cost effective investigative modality at the level of primary care medical facility for diagnosis of mass lesions in liver.
Fine needle aspiration cytology (FNAC) has proven to be an effective technique for diagnosis of liver lesion. Cytological examination of liver aspirates effectively differentiates between benign and malignant nature of the lesion, and helps in further management of the patient. The Present study aims at determining the utility of image guided FNAC of right hypochondrium masses with emphasis on diagnosis of neoplastic liver lesions. The present three year study was conducted on 135 patients from January 2016 to December 2019. After obtaining the detailed clinical and radiological data, patients were subjected for FNAC under Ultrasonography (USG) or Computed Tomography scans (CT scan) guidance. Out of 135 received liver lesions, the diagnostic yield was obtained in 129 cases (95.5%). Out of 129 cases, 101 (78.2%) were neoplastic and 28 (21.7 %) were non neoplastic. All 28 non-neoplastic lesions had infective etiology (25 bacterial and 3 protozoa infections). Amongst the 101 neoplastic lesions, 93% were malignant, 6 % benign and 1% was suspicious for malignancy. In malignant neoplastic tumors, 20.2% were HCC and were categorized into well differentiate (04), moderately differentiated (11) and poorly differentiated (04). Metastatic lesions constituted 75.5% in which possible primary could be suggested in 35 cases based upon cytomorphology, clinical history and radiological findings. The Majority of these cases are metastatic from gall bladder (14), gastrointestinal tract (06) and lung (07). Pancreatic and nasopharyngeal carcinoma metastasis were 02 in the number and 1 case of metastatic carcinoma each from prostate, urinary bladder, prostate and ovaries. Image guided FNAC of liver proves to be a minimally invasive and cost effective technique to characterize liver masses.
2010
Hepatocellular carcinoma (HCC) mostly occurs in chronic liver disease and cirrhosis. Liver resection and liver transplantation (LT) represent potentially curative treatments of choice and if not feasible, palliative strategies such as percutaneous interventional techniques (PITs) and chemotherapy (ChT) are considered. Elevated alfa-fetoprotein, typical imaging pattern, needle core biopsy (NCB) and fine needle aspiration cytology (FNAC) complement diagnostic assessment of HCC. We have retrospectively analyzed all patients with contraindications for NCB in which HCC was diagnosed by FNAC during consecutive 5 years in our hospital. Ultrasound guided FNAC provided a safe method of approach and, except for mild transitory discomfort at the site of puncture, no complications were documented. The diagnosis was established on May-Grünwald-Giemsa (MGG) stained aspirates and additional immunocytochemistry. Of our 62 patients, HCC developed in 61.3% cirrhotic and 38.7% non-cirrhotic livers. In the setting of cirrhosis 18.4% of patients underwent LT, 15.8% PITs, 26.3% ChT and 39.5% symptomatic therapy. In non-cirrhotic setting 46% of patients underwent liver resection, and PIT, ChT, and symptomatic therapy were applied in 4%, 25%, 25% of cases, respectively. Pathohistology of resected and explanted livers (18 cases) confirmed the initial diagnosis made on FNAC. Since only early stage of HCC has a better prognosis, every effort should be made to establish prompt and accurate diagnosis. Our observations demonstrate that FNAC offers minimally invasive, rapid and uncomplicated diagnostic approach, with sensitivity from 67% to 93% and specificity from 96% to 100%. FNAC, is of utmost importance in the setting of abnormal coagulation tests and ascites commonly seen in advanced liver disease, facilitating diagnostic workup and treatment decisions.
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2018
Radiologically guided fine-needle aspiration cytology (FNAC) of internal organs is not cost-effective. Rapid on-site evaluation (ROSE) of smears by a cytopathologist can improve the diagnostic yield of FNACs and save time and money by reducing the need for repeat procedure/biopsy. To determine the role of ROSE in the diagnostic outcome of hepatic lesions by comparative analysis of FNAC with and without ROSE by a cytopathologist. Hepatic FNACs were retrospectively analyzed over two separate time periods from January 2011 to June 2013 and from January 2015 to July 2016. Smears from 2015-2016 were subjected to ROSE by a cytopathologist after staining with toluidine blue for 1 min to assess adequacy of the material. Final report was given after hematoxylin and eosin, May Grünwald Giemsa, and Papanicolaou staining were performed. Chi-square test (non-parametric) was used to determine if there was a statistically significant increase in the diagnostic yield with ROSE. During 2011-2013, of...
Profile of Liver Fine Needle Aspiration in Tertiary Care Hospital
Euroasian Journal of Hepato-Gastroenterology, 2013
Objective: This retrospective study was planned to evaluate role of fine needle aspiration cytology (FNAC) in space occupying lesions of liver as first line investigation to differentiate benign from malignant pathologies, primary vs secondary malignancies and establishing exact diagnosis.
The Internet Journal of Gastroenterology, 2007
Objective: The aim of this study is to correlate between ultrasound guided fine needle aspiration cytology and ultrasound alone in the diagnosis of focal hepatic lesions. Methods: The study was prospective and was carried out between January 2002 and December 2005 at the University of Maiduguri Teaching Hospital. Abdominal ultrasound and ultrasound guided-fine needle aspiration cytology of forty-seven patients with clinical diagnosis of hepatic focal lesions was carried out. Results: Out of 47 patients diagnosed by USSG-FNAC, 37 were malignant, six as suspicious of malignancy, two as amoebic liver abscess and one case as metastatic carcinoma. The ultrasound diagnosed 43 cases as hepatoma (Malignant), 2 as abscesses, one case each as metastatic and liver cirrhosis. Malignancy (Hepatoma) is the commonest finding by both ultrasound and USSG-FNAC. Ultrasound diagnosed the abscesses, liver cirrhosis and metastatic carcinoma correctly as USSG-FNAC. Conclusion: In conclusion, USSG-FNAC may or may not be superior to ultrasound alone in the diagnosis of hepatic focal lesions.