The Role of Ultrasonically Guided Fine Needle Cytology in the Diagnosis of Focal Liver Lesions in Sulaimani-Kurdistan Region, Iraq

Abstract

Background: Fine Needle Aspiration Cytology (FNAC) under image guidance has gained increasing acceptance as the diagnostic procedure of choice for patients with focal hepatic lesions. It can be performed percutaneously or endoscopically. FNA may also be performed at laparoscopy or laparotomy under direct vision when image guided FNA fails to provide diagnostic tissue. In experienced hands, FNA is safe, minimally invasive, accurate, and cost-effective. However, the main aim of this study is to assess the role of FNAC in the evaluation of focal liver lesions. Patients and method: This prospective study was conducted over one year, on 100 patients in Kurdistan Center for Gastroenterology and Hepatology (KCGH) and in Sulaimani General Teaching Hospital. All patients were properly assessed by history analyses and thorough clinical examination. Laboratory investigations including hematological, biochemical, viral markers, and tumor markers were requested. Thus, ultrasonically guided FNA was performed after obtaining a written informed consent from the patients. Results: FNAC showed that eighty patients (80%) had secondary liver metastasis. Ten patients (10%) had HCC; three patients had hemangioma; one patient had abscess; and 6 patients had inconclusive result; two patients had simple cyst. Apart from mild post procedure pain, no complication or mortality had been recorded. Conclusion: FNAC is simple, easy, rapid and a minimally invasive procedure that has an acceptable diagnostic yield for focal liver lesions.

Cytodiagnosis of Hepatic Lesions and Their Association With Serum Alpha Fetoprotein Levels

“…In present study out of 43 cases of metastatic carcinoma, 38 cases showed normal serum AFP levels while 5 cases of metastatic carcinomas showed raised serum AFP levels. These results were in line with study done by Alkarboly et al [13] The present study showed that out of 5 cases of metastatic carcinomas having raised AFP levels, maximum value of serum AFP (345.61ng/mL) was seen with MDA followed by MDPDC (13.45±38.91 ng/mL) ( Table 2). All the cases diagnosed as MDSCC, inadequate and inconclusive cases had serum AFP levels of less than 8.5ng/mL.…”

“…In the present study showed that out of 56 cases, 28.6% of the cases had jaundice. These results were concordant with the study done by Alkarboly et al [13] While in study conducted by Ahuja et al only 12% cases presented with jaundice. [12] In study done by Sood et al 22.9% cases had history of alcohol abuse and considered it as an important etiological factor for various hepatic lesions.…”

“…[15] In the present study showed that 76.8% of the cases had multiple liver SOL's, while 23.2% of the cases had solitary lesion radiologically. These results are in line with study done by Alkarboly et al [13] and Agarwal et al [16] Sood et al studied the profile of HCC and found multicentricity in 57% cases of HCC on USG. [14] While Pawlik et al found 82% of the cases of HCC to have solitary lesion.…”

“…[22] Similarly Alkarboly et al found 60% cases of HCC having raised AFP levels. [13] In the present study, all 3 cases of HCC had serum AFP levels of more than 400ng/mL. In present study out of 43 cases of metastatic carcinoma, 38 cases showed normal serum AFP levels while 5 cases of metastatic carcinomas showed raised serum AFP levels.…”