Ultra-Sound Guided Fine Needle Aspiration Cytology in Diagnosis of Space Occupying Lesions of Liver with Special Emphasis on Hepato-Cellular Carcinoma

Background
The evaluation and management of various hepatic lesions is a common clinical problem and their
appropriate clinical management depends on accurate diagnoses.
Aims:
To study the cytomorphological features of distinctive non-neoplastic and neoplastic lesions of the liver
and to evaluate the sensitivity, specificity and diagnostic accuracy of ultrasonography (USG)-guided fine
needle aspiration cytology (FNAC) in the diagnosis of liver diseases.
Materials and Methods:
The study was performed on patients who came with SOL in liver on ultrasonography, with normal
range of prothrombin time index in SMS hospital, Jaipur. Procedure was performed on 172 patients
from 2 January 2016 to 16 sepetember 2016. USG Guided FNAC performed after getting an informed
consent & with the help of a radiologist. Relevant clinical and serological details were obtained from
every patient .
Results:
The mean age at presentation 56.47 years (25-95 years), ratio was almost equal male to female , male
patient were 91(52.9%) and female were 81(47.09%) out of 172. Adequate sample were 148(86.04) and
inadequate sample were 24 out of 172 patients. The cytological diagnosis of non neoplastic lesion were
total 10 in which granuloma 01(10%),liver abscess 4(40%),regenerating nodule 1(10%) , fatty liver
2(20%), cystic lesion 1(10%) and inflammatory lesions 1(10%). Neoplastic lesion were(135) more
common than non neoplastic lesions . The majority of neoplastic lesion were metastatic tumor
104(77.03%), followed by primary HCC23 (17.3%), unclassified malignancies 4(2.96%),
cholangiocarcinoma 4 (2.96%) out of total 135 cases. The overall diagnostic accuracy of FNAC was
97.82% with a sensitivity and specificity of 96.87 and 100% respectively.
Conclusion - USG-guided FNAC of the liver is a safe, simple, cost-effective and accurate method for
cytological diagnosis of hepatic diffuse, focal/nodular and cystic lesions with good sensitivity and
specificity