Impact of Image Guided Fine Needle Aspiration Cytology in Diagnosis of Pediatric Hepatic Mass and Cytohistologic Concordance

Overview

Journal J Indian Assoc Pediatr Surg

Specialty Pediatrics

Date 2014 Apr 18

PMID 24741212

Authors

Chhanda Das

Madhumita Mukhopadhyay

Moumita Sengupta

Ashis Kumar Saha

Biswanath Mukhopadhyay

Affiliations

Soon will be listed here.

Abstract

Background: Pediatric hepatic mass is a heterogeneous group of benign and malignant lesions. Percutaneous fine needle aspiration cytology (FNAC) can be utilized as a diagnostic modality to assess the nature of radiologically demonstrated hepatic lesions and thus facilitate individualized treatment.

Aims And Objective: The objective of the present study was to determine the diagnostic accuracy of percutaneous FNAC of pediatric liver masses, a procedure that is less invasive than open biopsy.

Materials And Methods: A prospective, observational study was carried out in the Department of Pathology in collaboration with Department of Pediatric surgery and Radio-diagnosis including 31 pediatric patients presenting over last two years (June 2011 to May 2013) with focal hepatic lesion on ultrasound and computed tomography (CT) scan. FNAC was carried out under image guidance and cytodiagnosis was reached after appropriate staining. By comparing with histopathology reports, diagnostic accuracy of cytology was evaluated.

Result: Among 31 cases included in the study, 51.6% cases were cytologically benign and hemangioma was the most common benign lesion. Hepatoblastoma was the most accounted malignant tumour (12.9%). FNAC provided 94% sensitivity and 92% specificity in diagnosing benign and malignant tumours. Overall diagnostic accuracy was 93.10%. No significant complication was noted.

Conclusion: Percutaneous FNAC under image guidance is an effective diagnostic tool for diagnosis of primary and metastatic tumours of liver in pediatric patients.

References

Wee A, Nilsson B, Yap I, Chong S . Aspiration cytology of liver abscesses. With an emphasis on diagnostic pitfalls. Acta Cytol. 1995; 39(3):453-62. View

Lundquist A . Fine-needle aspiration biopsy for cytodiagnosis of malignant tumour in the liver. Acta Med Scand. 1970; 188(6):465-70. DOI: 10.1111/j.0954-6820.1970.tb08069.x. View

Franca A, Valerio H, Trevisan M, Escanhoela C, Seva-Pereira T, Zucoloto S . Fine needle aspiration biopsy for improving the diagnostic accuracy of cut needle biopsy of focal liver lesions. Acta Cytol. 2003; 47(3):332-6. DOI: 10.1159/000326529. View

WEINBERG A, Finegold M . Primary hepatic tumors of childhood. Hum Pathol. 1983; 14(6):512-37. DOI: 10.1016/s0046-8177(83)80005-7. View

Bell D, Carr C, Szyfelbein W . Fine needle aspiration cytology of focal liver lesions. Results obtained with examination of both cytologic and histologic preparations. Acta Cytol. 1986; 30(4):397-402. View

Buscarini L, Fornari F, Bolondi L, Colombo P, Livraghi T, Magnolfi F . Ultrasound-guided fine-needle biopsy of focal liver lesions: techniques, diagnostic accuracy and complications. A retrospective study on 2091 biopsies. J Hepatol. 1990; 11(3):344-8. DOI: 10.1016/0168-8278(90)90219-h. View

Kuo F, Chen W, Lu S, Wang J, Eng H . Fine needle aspiration cytodiagnosis of liver tumors. Acta Cytol. 2004; 48(2):142-8. DOI: 10.1159/000326307. View

Swamy M, Arathi C, Kodandaswamy C . Value of ultrasonography-guided fine needle aspiration cytology in the investigative sequence of hepatic lesions with an emphasis on hepatocellular carcinoma. J Cytol. 2011; 28(4):178-84. PMC: 3214462. DOI: 10.4103/0970-9371.86344. View

Miller D, Carrasco C, Katz R, Cramer F, Wallace S, Charnsangavej C . Fine needle aspiration biopsy: the role of immediate cytologic assessment. AJR Am J Roentgenol. 1986; 147(1):155-8. DOI: 10.2214/ajr.147.1.155. View

10.

Bottles K, Cohen M, Holly E, Chiu S, Abele J, Cello J . A step-wise logistic regression analysis of hepatocellular carcinoma. An aspiration biopsy study. Cancer. 1988; 62(3):558-63. DOI: 10.1002/1097-0142(19880801)62:3<558::aid-cncr2820620320>3.0.co;2-2. View

11.

Radhika S, Rajwanshi A, Kochhar R, Kochhar S, Dey P, Roy P . Abdominal tuberculosis. Diagnosis by fine needle aspiration cytology. Acta Cytol. 1993; 37(5):673-8. View

12.

Das D, Tripathi R, Kumar N, Chachra K, Sodhani P, Parkash S . Role of guided fine needle aspiration cytology in diagnosis and classification of liver malignancies. Trop Gastroenterol. 1997; 18(3):101-6. View

13.

Layfield L, Mooney E, Dodd L . Not by blood alone: diagnosis of hemangiomas by fine-needle aspiration. Diagn Cytopathol. 1998; 19(4):250-4. DOI: 10.1002/(sici)1097-0339(199810)19:4<250::aid-dc4>3.0.co;2-e. View

14.

Cochand-Priollet B, Chagnon S, Ferrand J, BLERY M, Hoang C, GALIAN A . Comparison of cytologic examination of smears and histologic examination of tissue cores obtained by fine needle aspiration biopsy of the liver. Acta Cytol. 1987; 31(4):476-80. View

15.

Michielsen P, Duysburgh I, Francque S, Van der Planken M, van Marck E, Pelckmans P . Ultrasonically guided fine needle puncture of focal liver lesions. Review and personal experience. Acta Gastroenterol Belg. 1998; 61(2):158-63. View

16.

Chhieng D . Fine needle aspiration biopsy of liver - an update. World J Surg Oncol. 2004; 2:5. PMC: 400755. DOI: 10.1186/1477-7819-2-5. View

17.

Kassarjian A, Zurakowski D, Dubois J, Paltiel H, Fishman S, Burrows P . Infantile hepatic hemangiomas: clinical and imaging findings and their correlation with therapy. AJR Am J Roentgenol. 2004; 182(3):785-95. DOI: 10.2214/ajr.182.3.1820785. View

18.

Guo Z, Kurtycz D, Salem R, De Las Casas L, Caya J, Hoerl H . Radiologically guided percutaneous fine-needle aspiration biopsy of the liver: retrospective study of 119 cases evaluating diagnostic effectiveness and clinical complications. Diagn Cytopathol. 2002; 26(5):283-9. DOI: 10.1002/dc.10097. View

19.

Haas J, Muczynski K, Krailo M, Ablin A, Land V, Vietti T . Histopathology and prognosis in childhood hepatoblastoma and hepatocarcinoma. Cancer. 1989; 64(5):1082-95. DOI: 10.1002/1097-0142(19890901)64:5<1082::aid-cncr2820640520>3.0.co;2-g. View