Cytologic Diagnosis of hepatocellular Carcinoma by Fine-Needle Aspiration Biopsy.
- Author:
Ki Kwon KIM
1
;
Eun Sook CHANG
Author Information
1. Department of Pathology, keimyung University School of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
FNA;
Liver cell carcinoma;
Cytologic smear;
Cytomorphologic feature
- MeSH:
Adenocarcinoma;
Biopsy;
Biopsy, Fine-Needle*;
Carcinoma, Hepatocellular*;
Diagnosis*;
Diagnostic Errors;
Humans;
Liver;
Retrospective Studies;
Sensitivity and Specificity
- From:Korean Journal of Cytopathology
1990;1(1):18-26
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
CT guided percutaneous fine-needle aspiration(FNA) of the liver for both cytologic and histologic examination has great value in diagnosing liver malignancy. From March, 1986 to April, 1990, 62 patients with the clinical impression of liver malignancy underwent CT guided percutaneous FNA biopsy. Of these, 43 cases were reviewed for this study, 19 were reported to be liver cell carcinoma, 2 were adenocarcinoma, 11 were reported as anaplastic cell present, and the rest (11 cases) were negative (9) or necrotic (2). Among the 11 cases of the last group, 9 were diagnosed as liver cell carcinoma and 2 were necrotic histologically. Retrospective review, in order to clarify the casuse of cytologic diagnostic error, of both cytologic and histologic slides of all cases showed discordance of 23% between these diagnoses and sensitivity is 93.9% and specificity is 90.9%. The reasons were as follows :1) the lack of awareness of tumor cells of well differentiated liver cell carcinoma (4 cases), 2) missed tumor cells due to too scanty cellularity (1 case), 3) improper smear (2 cases) and no tumor cell in the cytologic smears (3 cases). In such cases, at the initiation of FNA, a correct diagnosis of liveer malignancy could only be made by a combination of cytologic and histologic examinations. However after three years' experience we can conclude that cytomorphologic features of liver cell carcinoma are sufficiently distinctive from other liver malignancies to be diagnostic
