Endoscopic ultrasoud-guided fine-needle aspiration biopsy for hepatic mass suspicious of malignancy

Abstract

Objective To investigate the diagnostic value of endoscopic ultrasound-gnided fine needle aspiration （EUS-FNA） biopsy in hepatic mass suspicious of malignancy. Methods This study retrospectively analyzed the clinical data of 29 patients （17 males and 12 females） with suspected hepatic malig- nancy aged from 30 to 80 years （ mean 57 -＋ 9. 7 years）. The yield of EUS-FNA were assessed by cell smear and histological examination. All patients were under close observation for complications after EUS-FNA. Results A total of 29 hepatic lesions （8 in caudate lobe, 19 in left lobe, and 2 in right lobe） and 32 extra- hepatic lesions （9 in pancreas, 2 in gallbladder, 1 in stomach, 1 in lung, 1 in right adrenal gland and 18 lymph nodes ） were fine-needle aspirated. All samples （61/61） were suitable for cell smear, 91.8% （56/61） for hematoxylin-eosin staining and 78.7% （48/61） for immunohistochemistry. In 29 patients, 8 were diagnosed as primary hepatic cancer （6 hepatocellular cancer, 2 cholangiocellular cancer）, and 21 were diagnosed as metastatic hepatic malignancy with 9 from pancreatic cancer, 3 from gallbladder cancer, 2 from lung cancer, 1 from gastric stromal tumor, 1 from gastric cancer, 3 from colorectal cancer and 2 from cancer with un-identified origin. No procedure related complications were observed in 29 patients. Conclusion Given the relationship between hepatic caudate lobe and cardia, left lobe and proximal stomach, deep right lobe and duodemum in topographic anatomy, and that EUS can easily scan enlarged mediastinal and retroperitoneal lymph nodes simuhaneously and guide FNA, EUS and EUS-FNA should be weighted in clinical practice. Key words: Biopsy, Fine-needle; Endosonography; Liver neoplasms; Pathology; Diagnosis