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Liver histology and cytology in the diagnosis of malignant liver disease.

Histologic and cytologic preparations from the saline rinsings of the Menghini biopsy were obtained from 193 patients with a variety of liver diseases. The results were analyzed to determine the sensitivity, specificity, and overall accuracy of the histologic, cytologic, and of the two combined methods. Thirty-four patients had malignant liver disease (MLD), whereas 159 patients had no evidence of MLD. Malignant neoplasms were detected by cytology alone in five patients, by histology alone in 15 patients, and by both histologic and cytologic findings in six patients. Liver cancer was not diagnosed by both methods in eight patients. The sensitivity of the cytologic, histologic, and combined cytologic and histologic results for detecting malignancy were 32.4%, 61.8%, and 79.4%, respectively, whereas the specificity was 100% for all methods. The overall accuracy was 88.1%, 93.2%, and 95.5%, respectively. This study demonstrates that cytologic examination of the fluid obtained by liver needle biopsy (LNB) has a high specificity and low sensitivity that increased the diagnostic yield of histology alone for detecting MLD by 14.7%.