For diagnosis of liver masses, fine-needle aspiration versus needle core biopsy: which is better?

Suo, Liye; Chang, Ruby; Padmanabhan, Vijayalakshmi; Jain, Shilpa

doi:10.1016/j.jasc.2017.09.004

Cited by 17 publications

(19 citation statements)

References 10 publications

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“…Consistently, a previous retrospective study enrolling 74 patients with liver masses also reported the better sensitivity of FNAC in metastatic cancers than in HCC. 7 Our study revealed a wider difference between the sensitivity of FNAC in diagnosing metastatic cancers and primary liver cancers (81.3% versus 66.0%). A plausible explanation is that the fine needle aspiration obtains fragmented tissue without the intact architecture and surrounding stroma, so the atypia of hepatocytes on cytology is not sufficient to make the definite diagnosis of HCC.…”

Section: Discussionmentioning

confidence: 56%

“…6 Some recent studies suggested that the accuracy of the two methods are comparable, and the FNAC might provide higher sensitivity in 7 metastatic liver mass. 7 Another study concluded the specimen from fine needle aspiration is accurate and produces higher tumor fraction for molecular studies than that from CNB. 8 However, most of prior studies focused on the pathologic diagnosis and findings.…”

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confidence: 99%

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Direct comparison of biopsy techniques for hepatic malignancies

et al. 2021

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Background/Aims: The core needle biopsy (CNB), fine needle aspiration cytology (FNAC) and touch imprint cytology (TIC) are commonly used tools for the diagnosis of hepatic malignancies. However, little is known about the benefits and criteria for selecting appropriate technique among them in clinical practice. We aimed to compare the sensitivity of ultrasound-guided CNB, FNAC, TIC as well as combinations for the diagnosis of hepatic malignancies, and to determine the factors associated with better sensitivity in each technique.Methods: From January 2018 to December 2019, a total of 634 consecutive patients who received ultrasound-guided liver biopsies at the National Taiwan University Hospital was collected, of whom 235 with confirmed malignant hepatic lesions receiving CNB, FNAC and TIC simultaneously were enrolled for analysis. The clinical and procedural data were compared.Results: The sensitivity of CNB, FNAC and TIC for the diagnosis of malignant hepatic lesions were 93.6%, 71.9%, and 85.1%, respectively. Add-on use of FNAC or TIC to CNB provided additional sensitivity of 2.1% and 0.4%, respectively. FNAC exhibited a significantly higher diagnostic rate in the metastatic cancers (P=0.011), hyperechoic lesions on ultrasound (P=0.028), and those with depth less than 4.5 cm from the site of needle insertion (P=0.036).Conclusions: The sensitivity of CNB is superior to that of FNAC and TIC for the diagnosis of hepatic malignancies. Nevertheless, for shallow (depth <4.5 cm) and hyperechoic lesions not typical for primary liver cancers, FNAC alone provides excellent sensitivity.

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Section: Discussionmentioning

confidence: 56%

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confidence: 99%

Direct comparison of biopsy techniques for hepatic malignancies

et al. 2021

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“…Moreover, owners of these patients often refuse these procedures to avoid their anesthetic risks, which then make the diagnosis inconclusive and specific treatment impossible. Ultrasound-guided fine-needle sample collection for cytology is used as a primary assessment of liver disease in human and veterinary patients because of its simplicity, speed, and low risk for complications [13][14][15][16] and remains the most commonly used staging technique for metastatic lymphoma [17]. Aspiration of the liver is recommended for the detection of lymphoma r egardless of its ultrasonographic appearance [18].…”

Section: Introductionmentioning

confidence: 99%

“…Case nos. 9, 11, 15, and16 were not included in this table because of inconsistency in the cytologic diagnosis. Case no.…”

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confidence: 99%

Comparison of fine-needle cytologic diagnosis between the left and right liver lobes of dogs and cats with diffuse liver disease

et al. 2021

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Background and Aim: Ultrasound-guided fine-needle sample collection for cytology with manual restraint is frequently used for the primary assessment of diffuse liver disease in veterinary patients in Thailand. For better diagnosis, repeated collection of samples ensures the collection of adequate, representative samples, which increase diagnostic accuracy. However, in those that are unable to receive general anesthesia, it is difficult to collect the samples from several liver locations in manually restrained dogs and cats. The study aimed to compare the cytologic diagnosis of the ultrasound-guided fine-needle non-aspiration technique between the left and right liver lobes in dogs and cats with neoplastic and non-neoplastic diffuse liver disease. Materials and Methods: This prospective study included 25 client-owned dogs and cats with diffuse liver diseases. Two liver samples were randomly collected from the left and right liver lobes under ultrasound guidance for cytologic examination. All slides were subsequently examined blindly by experienced pathologists for cytologic analysis with cytologic agreement scores (CASs). Results: Among all 50 samples obtained from ultrasound-guided fine-needle sample collection of the left and right liver, 78% were diagnostic and 22% were non-diagnostic. In the diagnostic group, 73.3% of fine-needle samples had concordant results between the left and right liver, which exhibited 100% cytologic agreement in lymphoma and 63.6% in non-neoplastic groups. Samples collected from the left liver had slightly higher CAS and higher cytologic quality than had those from the right liver lobe (p=0.053). Conclusion: The location and number of sample collections did not have a significant difference in the cytologic diagnosis of diffuse liver disease, especially in patients with lymphoma. For manually restrained patients, one time ultrasound-guided non-aspiration cytology procedure from the left liver lobe not only decreased restraint duration and minimized tissue trauma but also allowed for an adequate cytologic diagnosis in diffuse liver disease compared to multiple collections.

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“…Tissues obtained by FNA are often fragmented with distorted architecture and scant cellularity, making the diagnosis even more challenging. When compared to needle core biopsy, FNA has been shown to yield less diagnostic accuracy for HCC detection . However, FNA is fast, safe and inexpensive, and samples may be more representative than wide‐bore biopsies .…”

Section: Introductionmentioning

confidence: 99%

Loss of 5‐hydroxymethylcytosine immunohistochemical expression is a useful diagnostic aid for distinguishing hepatocellular carcinoma in cytology fine needle aspiration specimens

2019

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Objective: Disruption of the DNA methylation pathway involving 5-hydroxymethylcytosine (5hmC) has been implicated in hepatic tumour development. The aim of this study was to investigate the expression of 5hmC in malignant and benign hepatic mass lesions and evaluate the diagnostic utility of deficient 5hmC expression in hepatocellular carcinoma (HCC). Methods:Our study consisted of 48 fine needle aspiration (FNA) cytological cases (30 cases positive for HCC, 18 cases negative for malignancy) and 39 liver resection specimens (30 HCCs and nine hepatic adenomas [HAs]). A 5hmC immunohistochemistry score (range 0-9) was calculated by multiplying the percentage (0 = no staining; 1 = 1%-10%; 2 = 11%-50%; 3 = 51%-100%) and intensity scores (0-3+). A score of ≤2 was considered deficient for 5hmC. Results:In resection specimens, 5hmC expression was deficient in 90% of HCC cases. Surrounding cirrhotic nodules and 78% of HA cases exhibited intact 5hmC expression. In FNA cytological specimens, expression of 5hmC was deficient in nearly all cases of HCC (96.7%, 29/30 cases). Admixed benign hepatocytes exhibited predominantly intact expression of 5hmC with moderate to strong nuclear staining in the majority of the benign hepatocytes. 5hmC was strongly expressed by endothelial cells, lymphocytes and neutrophils in the background. Many 5hmC-negative HCC clusters were highlighted by characteristic endothelial wrapping with strong 5hmC expression in the endothelial cells.Conclusions: 5hmC can serve as an important diagnostic tool for the diagnosis of HCC by aiding in the distinction of HCC from HA or cirrhotic nodules in both liver resection and FNA specimens. K E Y W O R D S5-hydroxymethylcytosine, cytology, hepatocellular carcinoma, immunohistochemistry

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For diagnosis of liver masses, fine-needle aspiration versus needle core biopsy: which is better?

Cited by 17 publications

References 10 publications

Direct comparison of biopsy techniques for hepatic malignancies

Direct comparison of biopsy techniques for hepatic malignancies

Comparison of fine-needle cytologic diagnosis between the left and right liver lobes of dogs and cats with diffuse liver disease

Loss of 5‐hydroxymethylcytosine immunohistochemical expression is a useful diagnostic aid for distinguishing hepatocellular carcinoma in cytology fine needle aspiration specimens

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