[The diagnostic efficacy of ultrasonography-guided puncture cytology in hepatic masses]

The aim of this work was to evaluate the diagnostic reliability of fine needle cytology guided by ultrasonography in hepatic masses. One hundred and fifty nine patients underwent this procedure. The final diagnosis was confirmed by histology obtained by percutaneous biopsy, surgery, laparoscopy and necropsy or adequate clinical follow-up in 139 cases. Twenty cases were excluded since no final diagnosis was available. In 102 cases the method was applied on an outpatient basis, while the remainder were hospitalized. There were 9 (6.4%) false negatives, whose final diagnosis were hepatocarcinoma in 4, adenocarcinoma in 3, cholangiocarcinoma in 1 and in a non Hodgkin lymphoma. The global sensitivity of the method was 93.5%, the specificity 100% and the efficiency 93.5%. In hepatocarcinomas the sensitivity was 73.3%, the specificity 100% and the efficiency 73.3%. In metastatic adenocarcinomas the sensitivity was 96.2%, the specificity 100% and the efficiency 73.3%. Except for a single hepatocarcinoma patient who developed hemoperitoneum and 2 patients who required parenteral analgesics, complications were entirely lacking. Fine needle cytology guided by ultrasonography in hepatic masses is a highly efficient method to confirm, rule out and stage liver malignancy and benign lesions in a fast low-cost fashion. The low sensitivity in hepatocarcinomas is attributable to tumor size and histological differentiation.