Ultrasound- guided fine needle aspiration cytology and cell block in the diagnosis of focal liver lesions at Khartoum Hospital, Sudan

Abstract

Background: The appropriate clinical management of various hepatic lesions depends on accurate diagnosis. Fine needle aspiration and cell block have gained popularity because they are convenient, minimally invasive, quick and have good performance profiles.
Objective: To investigate the cytomorphological features of distinctive non-neoplastic and neoplastic lesions of the liver and to evaluate the sensitivity, specificity and diagnostic accuracy of ultrasound- guided (USG) fine needle aspiration cytology (FNAC) and cell block in the diagnosis of
liver diseases at Khartoum Teaching Hospital.
Method: A cross-sectional study was conducted at Khartoum Teaching Hospital, Sudan during the period of November 2008 to October 2011. One hundred and five cytological materials were collected from patients with focal liver lesions who referred after initial clinical and radiological
assessment for ultrasound–guided fine needle aspiration cytology (USG -FNAC).
Results: The age of the patients ranged from 5- 60 years and 64 (61%) of these patients were males. Out of 105 investigated samples 76 (72.4%) and 41(39.0%) were malignant by cytology and cell block respectively. Out of these 105 samples, 71 were investigated by both cytology and cell blocks and were included in the final analyses of the FNAC in comparison to cell block. The sensitivity, specificity, positive predictive value and negative predictive value of the cytology were 100% (93.0 – 100%), 63.3% (45.2 – 79.0%), 78.8% (66.2 – 88.3%) and 0 (0 – 14.6%), respectively.
Conclusion: Thus, USG -FNAC is a sensitive but not specific method in differentiating the benign and malignant focal liver lesions. Differentiation between primary liver malignant lesions and metastatic lesion needs adjunct technique

Key words: neoplastic lesion, non-neoplastic lesion