Detection of Malignant Cases From Focal Liver Masses by Fine Needle Aspiration Cytology and Cell Block

Abstract

Background and Objecive:  Fine needle aspiration cytology of the focal liver lesions in conjunction with cell block formation offers a  convenient, less invasive and better diagnostic tool. This study was carried out to determine the diagnostic accuracy of fine-needle aspiration cytology in comparison with cell block from the aspirates taken from focal liver masses. Methods:  This cross-sectional study was carried out over 13 months inthe Department of Pathology, Allama Iqbal Medical College Lahore, Pakistan in collaboration with the Department of Radiology, Jinnah Hospital Lahore, Pakistan. A total of 60 ultrasound-guided fine-needle aspiration cytological smears along with cell block material were collected from patients with focal liver lesions.Features of malignancy were noted on the fine-needle aspiration of liver lesions followed by cell blocks. Results:  Cytological diagnosis based on FNAC in 59 cases was benign, out of which 39 (66.0%) were amoebic liver abscess, 14 (23.7%) were pyogenic liver abscess, 2 (3.4%) were tuberculous hepatic abscess supported by the same findings on cell block. One case (1.7%) was diagnosed as malignant on FNAC, later on, confirmed by the cell block. Four (6.7%) cases on FNAC were reported as benign lesions which were later on diagnosed as hepatocellular carcinoma on the cell block. Taking cell block as gold standard, the sensitivity, specificity, positive predictive value negative predictive value and diagnostic accuracy of FNAC was 93%, 100%, 100%, 20% and 93.3% respectively. Conclusion:  Accurately sampled FNA smears supplemented by cell-block preparation considerably improve the false positive or negative diagnosis.