Percutaneous fine-needle aspiration biopsy of the liver. Cytodiagnosis of hepatic cancer.

Percutaneous fine-needle aspiration biopsies of the liver were performed on 21 patients with a clinical suggestion of hepatic malignancy. Under the guidance of the liver scan, several aspirations at the suspect areas were made in each case, with an average of 3.4 punctures and 13.8 smears per case. The biopsies were positive in 13 cases: 12 metastatic carcinomas and 1 hepatocellular carcinoma. There were no false-positive or false-negative results in this series. On the 13 patients with proven hepatic malignancy, 47 punctures had been performed. Of these 47 punctures, 34 (72.3%) were positive for malignant cells. Neoplastic tissue or cells were found from at least one aspirate in these 13 biopsies. Liver biopsies by Menghini technique were also performed on five patients with proven hepatic malignancy in this series. Of these five biopsies, only two showed evidence of malignancy. Typing of the tumors and determination of the primary sites based on cytomorphologic features in all the malignant cases were attempted. Origins of neoplastic cells were suggested in 11 cases and all confirmed in the follow-ups. The punctures and aspirations of these 21 biopsies did not reveal any immediate complication. Multiple fine-needle liver aspirations under the guidance of liver scan are of great diagnostic value with high accuracy in detecting hepatic malignancy.