Triumphs and Tribulations of Cytology in Malignant Hepatic Lesions

Background Guided fine-needle aspiration cytology (FNAC) is an easy, rapid and a minimally invasive diagnostic method for detecting neoplastic and non-neoplastic lesions of liver. Hepatic malignancies, both primary and secondary present as space occupying lesions clinically and radiologically, however, they differ in prognosis and management, hence it is mandatory to distinguish them. Material and Methods All patients, irrespective of age and sex, who presented with nodular hepatic lesions to the hospital from 1st January 2015 to 31st June 2016 were subjected to FNAC under radiological guidance. Rapid onsite evaluation (ROSE) was performed for adequacy of diagnostic material. Haematoxylin and Eosin (H& E), Giemsa stain and Papanicolaou stain were done as per protocol. Results Of the total 100 aspirates, 3 % were non-diagnostic, 3 % were suspicious of malignancy, 21 % were diagnosed as primary epithelial malignancy and 60 % were diagnosed as metastatic deposits and 13 % as malignant NOS. Conclusion In most hepatic malignancies, surgery is not an option. Thus, differentiation between primary or secondary tumours is extremely important from management point of view. Guided FNAC is a rapid, accurate and cost-effective method not only for detecting malignancy but also subtyping them. Hence, FNAC is a diagnostic technique with high sensitivity& specificity.