IMAGE GUIDED FNAC OF HEPATOBILIARY LESIONS WITH RADIOLOGICAL CORRELATION.
DOI:
https://doi.org/10.22159/ajpcr.2024v17i78.51342Keywords:
Liver Cytology, Hepatocellular Carcinoma, Liver Metastases, Gall Bladder, Liver SOLAbstract
Objective: The clinical and radiological presentations of both primary and metastatic hepatobiliary tumours can be similar–as a space occupying focal mass. FNAC can play a decisive diagnostic role minimizing the requirement of biopsy. Therefore, the present study was undertaken to evaluate various hepatic and gall bladder lesions on the basis of their cytomorphological features upon Ultrasound/CT guided FNAC and to study their correlation with radiological findings.
Methods: The patients presenting with liver enlargement, gall bladder masses, radiologic evidence of focal/diffuse and nodular hepatic lesions were subjected to ultrasound guided fine needle aspiration, which was performed using 22-gauge lumbar puncture needle with 20/50 cc disposable syringe under ultrasound/CT guidance. Subsequently smears were fixed and stained according to standard protocol and cytomorphological examination was done in the department of pathology. Analytical tests (Mc-nemar’s test for p-value and kappa test test for kappa value) were applied for cytological and radiological correlation.
Results: Among 100 patients, liver lesions accounted for 79 cases and gallbladder lesions accounted for 21 cases. On FNAC, liver lesions were categorized into 91.23% cases of neoplastic lesions, 6.33% as non-neoplastic lesions and 2.53% as indeterminate/non-diagnostic cases. Radiological-cytological correlation was seen in 43/79 cases (54.43%). Gall bladder lesions were categorized into 9.52% as non-neoplastic, 85.71% as neoplastic and 4.77% as indeterminate/non-diagnostic. Radiological-cytological correlation was seen in 7/21 cases (31.25%).
Conclusion: Radiologically guided fine needle aspiration is a very useful test in diagnosing liver and gall bladder lesions as it is simple to perform, cost-effective, safe and a quick procedure leading to early diagnosis.
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References
Naggada HA, Ahidjo A, Ajagi N. Correlation between ultrasound findings and ultrasound guided FNAC in the diagnosis of hepatic lesions: A Nigerian tertiary hospital experience. Int J Gastroenterol. 2006;5(2):1-5.
Das DK, Tripathi RP, Bhambhani S, Chachra KL, Sodhani P, Malhotra V. Ultrasound-guided fine-needle aspiration cytology diagnosis of gallbladder lesions: A study of 82 cases. Diagn Cytopathol. 1998;18(4):258-64. doi: 10.1002/(sici)1097- 0339(199804)18:4<258:aid-dc2>3.0.co;2-8, PMID: 9557259
Roy SK, Sultana S, Mollah NU, Yasmin T, Sarker A, Jahan MU. Role of ultrasonography in diagnosis of solid space occupying lesion in the liver correlation with FNAC. Bangladesh Med Res Counc Bull. 2015;41(2):81-8. doi: 10.3329/bmrcb.v41i2.29986, PMID: 29624286
Meena SP, Patangia P, Rai NN. Diagnostic utility of USG-guided FNAC in hepatic lesions. J Evid Based Med Healthc. 2016;3(52):2699-702. doi: 10.18410/jebmh/2016/591
Goel S, Hemrajani D, Sharma M. Ultrasound guided fine needle aspiration cytology (FNAC) in diagnosis of space occupying lesions (SOL) of liver. J Evol Med Dent Sci. 2014;3(27):7480-6.
Dalsaniya SB, Shah MG, Patel TS, Gandhi JS, Jetly DH, Trivedi PP. Evaluation of liver space occupying lesions by fine needle aspiration cytology. Int J Curr Res Rev. 2016;8(24):13-8.
Balani S, Malik R, Malik R, Kapoor N. Cytomorphological variables of hepatic malignancies in fine needle aspiration smears with special reference to grading of hepatocellular carcinoma. J Cytol. 2013;30(2):116-20. doi: 10.4103/0970-9371.112655, PMID: 23833401
Swamy MC, Arathi CA, Kodandaswamy C. Value of ultrasonography-guided fine needle aspiration cytology in the investigative sequence of hepatic lesions with an emphasis on hepatocellular carcinoma. J Cytol. 2011;28(4):178-84. doi: 10.4103/0970-9371.86344, PMID: 22090691
Arathi S, Giriyan S. Ultrasound guided FNAC in diagnosis of space occupying lesions of Liver. Indian J Pathol Res Pract. 2017;6(2):360-4.
Bhartiya R, Mallick S, Mallik M, Agrawal P, Singh R, Singh RV. Ultrasound-guided fine-needle aspiration cytology diagnosis of gall bladder lesions with the application of WHO histological classification of tumors on cytoaspirate material. Ann Trop Med Public Health. 2017;10(1):138-42. doi: 10.4103/1755-6783.196595
Ahmad SS, Akhtar K, Akhtar SS, Nasir AA, Mansoor T. Ultrasound guided FNA biopsy of abdominal masses. JK Sci. 2006;8:200-4.
Kumar N, Singhal P, Agarwal A, Khan MA. Cytopathological diagnosis of gallbladder mass and mural thickening based on imaging findings: A prospective study of 51 cases. J Cytol. 2015;32(4):234-7. doi: 10.4103/0970-9371.171231, PMID: 26811570
Handa U, Nanda A, Mohan H, Kochhar S, Sachdeva A. Cytologic diagnosis of gallbladder lesions - a study of 150 cases. Indian J Surg. 2010;72(3):181-4. doi: 10.1007/s12262-010-0047-y, PMID: 23133243
Nazir RT, Sharif MA, Iqbal M, Amin MS. Diagnostic accuracy of fine needle aspiration cytology in hepatic tumours. J Coll Physicians Surg Pak 2010;20(6):373-76.
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Copyright (c) 2024 Dr. Prerna Chhabra, Dr. Sarita Nibhoria, Dr. Sahil Chhabra, Dr. Shivani Puri
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