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Percutaneous fine‐needle aspiration cytology in the diagnosis and management of liver tumours. BJS 2002; 89: 757-762.

Published: 5th November 2002

Authors: B. Ohlsson, J. Nilsson, U. Stenram, M. Åkerman, K.‐G. Tranberg

Background

The aim of the study was to investigate the value of percutaneous fine‐needle aspiration cytology (FNAC) in the diagnosis and management of liver tumours.

Method

FNAC followed by histopathological examination was carried out in 216 patients with suspected liver tumours. The final diagnosis was primary liver cancer in 106, colorectal metastases in 51, non‐colorectal metastases in 46, benign tumour in nine and no tumour in four patients.

Results

Cytology resulted in correct classification of the lesion as benign or malignant in 87 per cent of patients, correct discrimination between primary and secondary malignancy in half of the patients, and a correct diagnosis of tumour type in one‐third of patients. The tumour was erroneously classified as benign or malignant in 22 patients (11 per cent) and four patients (2 per cent) respectively. When FNAC showed malignancy, the predictive value was 98 per cent, whereas the predictive value was 27 per cent when it did not. FNAC guided investigations and treatment in one‐quarter of patients. Implantation metastases were recorded in seven patients (3 per cent), including five (10 per cent) of 51 patients with colorectal liver metastases, and caused major local problems and death in four patients.

Conclusion

FNAC was valuable in about a quarter of patients with liver tumour. The risks of implantation metastases and a false‐negative finding do not justify its use in candidates for curative therapy of liver tumours. © 2002 British Journal of Surgery Society Ltd

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