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Fine-needle aspiration cytology in liver tumors.

Liver tumors are commonly encounted in Taiwan. Differential diagnosis between primary and metastatic cancer is easily made by liver biopsy. Howerver, liver biopsy bears the risk of hemorrhage and needle tract implantation. Other noninvasive diagnostic methods, e.g. ultrasonography, liver scan, and CT are less specific in confirming the diagnosis. Angiography is expensive, risks high X-ray exposure and is relatively invasive. From May 1984 to August 1985,50 patients with liver tumors underwent percutaneous fine needle aspiration of the liver for cytological study. Among these patients, 43 cases were cytologically diagnosed as primary hepatocellular carcinoma which were later verified by histopathology, α-fetoprotein (AFP) and/or angiography. Seven patients were diagnosed as having metastatic cancer. The 7 patients were confirmed by histopathology in 6 patients in subsequent investigations including 2 colon cancers, 1 pancreatic cancer, 1 lung cancer, 1 nasopharyngeal cancer and 1 malignant melanoma. One case was initially diagnosed as metastatic cancer, but was later proved by histopathology to be hepatoma. The accuracy of this technique for diagnosing liver tumors was 98%. Neither bleeding nor needle tract implantation has been noted so far. Accordingly, we recommend that fine needle aspiration is a safe, rapid and accurate method for the diagnosis of liver tumors.