Role of guided fine needle aspiration cytology in mass lesions of liver

Abstract

Introduction: High incidence of liver diseases is seen in our country. Diseases of liver that present as a mass lesion can be a diagnostic dilemma. Nowadays guided fine needle aspiration cytology (FNAC) is utilized with greater frequency to identify and diagnose such lesions. The present study was carried out to investigate the profile of liver diseases presenting as a mass lesion in a primary care setting, using guided FNAC as a diagnostic tool. Amongst these patients, efficacy of FNAC in segregating a cohort that needs palliative care only – at the level of primary care medical facility - is also analysed. This would help in minimizing the economic burden of the patient and the expenditure entailed by the society; thereby allowing proper use of scarce medical facilities in resource poor countries. Methods: CT or ultrasound guided FNAC was carried out in 83 patients in a primary medical care facility. Based on cytological diagnosis, their demographic profile was analysed. Results: Primary or secondary malignancy was diagnosed in 46 patients. Metastatic carcinoma comprised the predominant group amongst neoplastic lesions of the liver. In 28 patients, diagnosis of pyogenic or amoebic abscess or hydatid cyst was made. It was possible to identify with the help of guided FNAC, a group of patients suitable for palliative care only. Conclusions: Guided FNAC is a cost effective investigative modality at the level of primary care medical facility for diagnosis of mass lesions in liver. Keywords: Guided aspiration cytology, Mass lesions of liver, Pyogenic liver abscess, liver metastasis