Role of Ultrasonography Guided Fine Needle Aspiration Cytology (FNAC) of Hepatic Lesions and Its Histopathological Correlation

Background: The liver is the largest internal organ of the body. The present study was carried out to evaluate the diagnostic efficacy of guided FNAC in neoplastic and non-neoplastic focal lesions of the liver. Materials & Methods: Seventy-two patients admitted to or attending the OPD of Nalanda Medical College and Hospital with suspected hepatic lesions. The present study included a total of 72 fine needle aspirates obtained from patients who visited our pathology department with various space-occupying lesions of the liver. Ultrasonography was done. For histopathological examination, the core needle biopsy was performed concurrently with the FNA under local anaesthesia and ultrasound guidance using the Vim-Silverman liver biopsy needle, wherever possible. The tissue obtained was fixed in 10% formalin and processed. The paraffin sections were stained with routine H & E stains. All the results were recorded in a Microsoft Excel sheet and were subjected to statistical analysis using SPSS software. Results: Cytological diagnosis was neoplastic lesions in 69.56 percent of the patients, while it was non-neoplastic lesions in the remaining 30.43 percent of the patients. Statistical Indices of FNA Diagnosis as calculated by the Galen and Gambino method: Sensitivity: 94.12% Specificity: 80% Positive Predictive Value (PPV): 96.97% Negative Predictive Value (NPV): 66.67% Diagnostic Accuracy: 92.31% Area Under Curve (AUC): 0.871 P value: 0.001 (Significant). Conclusion: Guided FNAC is a safe, useful, and economic procedure with virtually no complications and can be routinely done for assisting the diagnosis of liver diseases in our clinical setup. USG/CT guidance offers a better approach to hepatic lesions and avoids injury to vital abdominal structures.