Ultrasound Guided FNAC in Diagnosis of Space Occupying Lesions of Liver
Journal Title: Indian Journal of Pathology: Research and Practice - Year 2017, Vol 6, Issue 2
Abstract
Introduction: Liver is one of the most common sites for both neoplastic and nonneoplastic lesions. In the suspected liver diseases ultrasound is the first and most important diagnostic tool. As sonography alone has its limitations, cytomorphologic analysis by FNA is required to increase the diagnostic accuracy. Aims and Objectives: To evaluate various neoplastic and nonneoplastic lesions encountered in the liver and to correlate ultrasound findings with the USG FNA diagnosis in liver lesions. Materials and Methods: This was a prospective study comprising of 102 cases of liver lesions diagnosed clinically or radiologically.Abdominal ultrasonography was carried out in all cases. FNAC was performed under ultrasound guidance. Smears were stained with H & E and Wrights stain and were examined for detailed cytomorphological analysis. Observation and Results: The mean age of the patient was 53yrs with M: F ratio of 1.5:1. Out of 102 cases, 3 cases (2.94%) each of inflammatory, cirrhosis, regenerative hyperplasia, one case (0.98%) of simple hepatic cyst, and 83cases (81.37%) were malignant, while one case (0.98%) was suspicious of malignancy. Eight (7.84%) cases were inconclusive. Thus diagnosis was possible in 94 cases with diagnostic yield of 92.2%. Malignant liver aspirates formed vast majority 83 cases (81.37%).Of these 83 cases, primary malignant liver lesions formed 42 cases (50.6%). Out of these 42 cases, 40 cases were hepatocellular carcinoma and two cases were NHL. Metastatic tumour constituted 41 cases (49.4%) of which 35 cases were adenocarcinoma deposits, five cases were Squamous cell carcinoma deposits and one case of lymphoma deposit was found. On ultrasound examination out of 40 cases of HCC, 32 cases had solitary SOL, and 8 cases had multiple SOL. Metastatic carcinoma group showed solitary lesions in 10 cases and multiple lesions in 30 cases. All 3cases of NHL presented as multifocal lesions. Ultrasound diagnosis correlated well with 73 cases out of 90 cases. Discrepancies were found in 17 cases of hepatic lesions between ultrasound diagnosis and cytological diagnosis. Conclusion: Malignant tumors were the commonest of the liver lesions with same incidence of primary and metastatic deposits. HCC presented as solitary lesion and deposits presented with multiple SOLs in most of the cases. On radiological examination, neoplastic and nonneoplastic lesions show overlapping features, hence cytomorphological analysis by FNAC increases the diagnostic accuracy.
Authors and Affiliations
Arathi S.
Keywords
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- EP ID EP464152
- DOI 10.21088/ijprp.2278.148X.62(pt-II)17.3
- Views 96
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