We reviewed 119 percutaneous, radiologically guided fine-needle aspirations (FNA) from 114 patients with liver masses to evaluate diagnostic effectiveness and complications of this procedure. Satisfactory material was obtained in 118 cases (99%), of which 78 were diagnosed as positive (66%), three suspicious (2%), five atypical (4%), and 32 (27%) as negative for malignancy. Compared to surgical biopsy (48 cases) and clinical data, the sensitivity and specificity of FNA for malignancy was 95.1% and 100%, respectively, yielding a positive predictive value of 100% and a negative predictive value of 88.8%. Four cytology cases (3.4%) were false-negatives (FN); all were interpretive errors. Four FN surgical biopsies (8.3%) were sampling errors. Minor complications occurred in three cases (2.5%). We conclude that FNA is safe and effective for determining the malignant potential of liver masses and should be the procedure of choice. Our experience suggests that having a pathologist present in the radiology suite provides optimal patient care.

Fine-needle aspiration (FNA) of the pelvis and retroperitoneum (excluding the pancreas, kidney, and adrenal masses) has not achieved its full potential as a diagnostic modality. We reviewed 68 percutaneous, radiologically guided FNAs from these locations to assess the clinical utility and complication rate of this procedure. Satisfactory material was obtained in 66 cases (97.1%), of which 37 were deemed positive (55%), 3 suspicious (4%), 4 atypical (6%), and 22 negative (32%) for malignancy; two cases (3%) were unsatisfactory. Compared to biopsy (36 patients) and clinical information, the sensitivity and specificity of FNA for malignancy were 90.2% and 100%, respectively, yielding a positive predictive value of 100% and a negative predictive value of 86.6%. The four false-negative cases (5.9%) were due to sampling error. One patient had a minor complication (hematoma) from the procedure. We conclude that FNA is the procedure of choice for detecting most malignancies in these two locations.

Fibromatosis colli is a benign disorder presenting as a neck mass in neonates and older children. The differential diagnosis includes malignancies such as rhabdomyosarcoma. Neck masses in ten infants, discovered between the second and sixth week of age, were evaluated by fine-needle aspiration (FNA). The male to female ratio was 7:3. In 8 patients there was good obstetrical history. Six of the 8 patients had a difficult delivery, as indicated by breech presentation or the need for forceps. Diagnostic aspirations were performed between the second to ninth week of age. The major cytologic finding was benign spindle fibroblasts, usually arrayed in clusters. The cells possessed plump, ovoid nuclei. There were also multinucleated cells consistent with degenerating skeletal muscle fibers. Only one case demonstrated significant inflammation. FNA can provide a rapid and reliable diagnosis in fibromatosis colli. There is support for the idea that in this setting, the disorder is related to perinatal muscular trauma. Diagn. Cytopathol. 2000;23:338 -342.