Fine-needle aspiration biopsy of hepatic lesions: computerized tomographic-guided versus endoscopic ultrasound-guided FNA.
Author(s): Crowe DR, Eloubeidi MA, Chhieng DC, Jhala NC, Jhala D, Eltoum IA
Publication: Cancer, 2006, Vol. 108, Page 180-5
PubMed ID: 16634071 PubMed Review Paper? No
Purpose of Paper
This paper compared the diagnostic accuracy of computerized tomographic (CT)-guided and endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) biopsies of liver lesions.
Conclusion of Paper
While there were no significant differences in the percentage of malignant, atypical, and benign diagnoses between the EUS-FNA and CT-FNA groups, benign GI epithelial cells were found in 60% of EUS-FNA specimens but were not observed in any of the CT-FNA specimens. When present, histology of additional biopsies or biopsies of additional tissues confirmed the diagnosis of eight of nine CT-guided FNA and ten of eleven EUS-FNA, with each method resulting in a single false-negative for carcinoma.
Studies
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Study Purpose
This study compared the diagnostic accuracy of CT-guided and EUS-guided FNA biopsies of liver lesions. All FNA were obtained by inserting a 22-gauge (G) needle into the lesion, removing the stylet, and moving the needle back and forth for 15-20 seconds without suction, unless no material was obtained. Generally, three passes were performed. CT-guided FNA were obtained from 34 patients by one of several different radiologists but all 16 EUS-guided FNA were obtained by a single gastroenterologist. Aspirates were placed on slides, ethanol-fixed and papanicolaou-stained and then air-dried and Diff-Quik stained. Histology was available for a concurrent or subsequent liver biopsy for 9 of the 34 CT-FNA specimens and 1 of the 16 EUS-FNA specimens, and from other tissues for 10 of the EUS-FNA specimens.
Summary of Findings:
While there were no significant differences in the percentage of malignant, atypical, and benign diagnoses between the EUS-FNA and CT-FNA groups, benign GI epithelial cells were found in 60% of EUS-FNA specimens but were not observed in any of the CT-FNA specimens. Histology confirmed malignancy in all of the four cases that were classified as malignant based on cytology and the three cases that were diagnosed by cytology as suspicious of malignancy. Further, histology confirmed two of the three benign diagnoses by cytology with the third (a CT-FNA) revealing a benign lesion, a bile duct hematoma, and two foci of metastatic melanoma after surgical resection. Nine of the EUS-FNA had matched specimens positive for pancreatic malignancy of which six were positive for metastatic carcinoma, two were atypical, and the third was negative for carcinoma.
Biospecimens
Preservative Types
- Other Preservative
- Ethanol
Diagnoses:
- Neoplastic - Benign
- Neoplastic - Carcinoma
Platform:
Analyte Technology Platform Morphology Light microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Method of cell acquisition EUS-FNA
CT-FNA