Journal of Cytology

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 38  |  Issue : 1  |  Page : 21--30

Efficacy and validity of image-guided percutaneous fine needle aspiration and core biopsy of liver pathologies: Saga of focal hepatic lesions from the nodule to the needle to the slide


Santosh Phajir Vishwanath Rai1, Vinay KM Kumar2, Sridevi Hanaganahalli Basavaiah3, Saraswathy Sreeram3, Sandeep Gopal4, Bailuru Vishwanath Tantry4 
1 Department of Radiodiagnosis and Imaging, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
2 Post Graduate Student, Department of Radiodiagnosis and Imaging, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
3 Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
4 Department of Gastroenterology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

Correspondence Address:
Dr. Sridevi Hanaganahalli Basavaiah
Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka - 575 001
India

Context: Radiology and pathology are pivotal tools in the investigational artillery for management of wide spectrum of hepatic lesions and early detection is of a paramount importance. Aims: The study aimed at analyzing the efficacy, comparative yield and validity of image-guided aspiration cytology (FNA)/core biopsy (CB) in focal hepatic lesions. Settings and Design: A retrospective hospital-based study was conducted in departments of Pathology and Radiology and Imaging of a tertiary care center. Materials and Methods: Cases of focal hepatic lesions that underwent percutaneous image guided-FNA reported (2011-2018) were analyzed. Cytological-histopathological correlation was performed where available. FNA diagnoses were divided into four categories-positive for malignancy (group 1), atypical (group 2), negative for malignancy (group 3), and non-diagnostic (group 4). Statistical Analysis Used: Categorical data was depicted in the form of frequencies and proportions. Validity of percutaneous image-guided FNA diagnosis was collated with the final diagnosis and results were analyzed. Results: A total of 338 FNA of focal hepatic lesions were reported in which 217 (68.2%) cases in group 1; 21 (6.2%) in group 2; 58 (17.2%) in group 3 and 42 (12.4%) in group 4. CB correlation was available in 123 cases. Based on clinical, radiological and pathological findings, conclusive final diagnoses were obtained and the cases were regrouped [malignant cases-245, benign lesions-57 and uncertain lesions-36]. Metastasis was the most common malignancy (175/245; 71.4%). Sensitivity, specificity, and overall diagnostic accuracy of FNA to categorize the lesion as benign or malignant were 96.94%, 100% and 97.51%, respectively. However, the cytology-histopathology correlation revealed discordance of subtyping the lesion in 20% of cases and sensitivity and specificity reduced to 80% and 50% respectively in rendering the specific diagnosis. Conclusions: Percutaneous image-guided FNA is a sensitive and specific tool with high diagnostic accuracy in evaluating focal hepatic lesions. The study highlights the pre-eminence of interventional radiology and cytology in the care of patients with liver lesions.


How to cite this article:
Rai SP, Kumar VK, Basavaiah SH, Sreeram S, Gopal S, Tantry BV. Efficacy and validity of image-guided percutaneous fine needle aspiration and core biopsy of liver pathologies: Saga of focal hepatic lesions from the nodule to the needle to the slide.J Cytol 2021;38:21-30


How to cite this URL:
Rai SP, Kumar VK, Basavaiah SH, Sreeram S, Gopal S, Tantry BV. Efficacy and validity of image-guided percutaneous fine needle aspiration and core biopsy of liver pathologies: Saga of focal hepatic lesions from the nodule to the needle to the slide. J Cytol [serial online] 2021 [cited 2021 Apr 23 ];38:21-30
Available from: https://www.jcytol.org/article.asp?issn=0970-9371;year=2021;volume=38;issue=1;spage=21;epage=30;aulast=Rai;type=0