Fine needle trucut biopsy in focal liver lesions: a reliable and safe method in identifying the malignant nature of liver lesions.

ABSTRACT

BACKGROUND AND STUDY AIMS: The correct management of a focal liver lesion, suspected of being malignant, requires tissue for histopathological examination. To this purpose an ultrasonically guided fine needle trucut biopsy technique (FNTCB) can be used, to allow obtaining large tissue samples. The aim of the study is to see that FNTCB is a reliable method in identifying the malignant or benign character of a focal liver lesion. PATIENTS AND METHODS: We retrospectively compared the results of 231 FNTCB of focal liver lesions with the final diagnosis. RESULTS: In 191 lesions a final diagnosis was obtained (164 were malignant, 27 were benign). In our series FNTCB has a sensitivity of 86.6% (142/164), a specificity of 100% (27/27) and an overall accuracy of 88.5% (169/191) in identifying malignancy. There was a correct identification in 79.4% (27/34) of primary liver tumours and 88.5% (115/130) of liver metastases. In 52% (60/115) of liver metastases the primary site was accurately suggested by the pathologist. Correct characterization of benign liver lesions was obtained in 63% (17/27) of the cases. The insufficient sample rate was 3.1% (6/191). In one patient with thrombocytopenia an intraabdominal haemorrhage occurred. CONCLUSIONS: FNTCB is a reliable and safe method in identifying the malignant nature of liver lesions. Due to the large tissue sample, insufficient sample rate is low and an accurate histological identification of benign lesions, primary liver malignancies and metastases can be made. In case of metastases it is often possible to determine the site of the primary tumour.