Role of Ultrasound guided Fine needle Aspiration in diagnosis of liver mass lesion

Abstract

Fine Needle Aspiration of the liver is a simpler technique and is reported to yield higher positivity in patients with hepatic malignancy as compared to core biopsy. Fine needle aspiration cytology has the advantage of causing significant less discomfort and a very low risk of complication. Of all the radiological procedures the ultrasound is most suited for fine needle aspiration cytology as real time images can be obtained and it prevents the perforation of gall bladder, colon and blood vessels, Ultrasound has higher level of practicality, requires no ionizing radiation and is widely applicable as compare to computerised tomography scan. Aim of the present study is to establish role of Ultrasound guided Fine Needle Aspiration in diagnosis of liver mass lesions. Methods : We have performed UGS guided FNAC on 42 suspected cases of liver mass lesion. Detail history, clinical examination was done and consent was taken from patient after explaining the procedure to them. Bleeding time, Clotting time and Prothrombin time were done prior to procedure. All patients with liver mass lesion diagnosed on radiology were included in the study. Under all aseptic precaution Ultrasound guided FNAC was done from liver mass lesion using 26 gauge lumbar puncture needle. The material obtained in the needle was expelled onto glass slide and smear was made by opposition technique. Results: Of 42 aspirates from liver, 13 were diagnosed as hepatocellular carcinoma, 23 were diagnosed as metastatic carcinomas. Attempt of grading and study of cellular patterns was done in hepatocellular carcinoma. Of 23 cases of metastatic carcinoma, in 11 cases primary site could be demonstrated. In 12 cases primary site could not be determined. 18 were adenocarcinomas and 5 were undifferentiated anaplastic carcinoma. Conclusion: Ultrasound guided Fine Needle Aspiration of liver mass is safe ,cost effective technique in localizing Liver lesion and acquiring adequate material for preoperative diagnosis of mass lesion of liver