Fine needle aspiration cytology in the diagnosis of hepatocellular carcinoma.

Fine needle aspiration (FNA) of the liver without ultrasound guidance was performed on 110 patients with hepatocellular carcinoma (HCC). The median age was 52 years, with a range of 16 to 86 years. There were 90 males and 20 females (a male: female ratio of 4.5:1), with a median age of 51.5 years (range 16 to 86 years) and 55.5 years (range 17 to 72 years) respectively. FNA was reported as showing malignancy in 92 (84 pc, 95 pc CI 77 to 91 pc) patients; 80 (73 pc) were definite HCC, 12 (11 pc) were malignant unspecified, seven (6 pc) were suspicious of malignancy, seven (6 pc) had no malignant cells and four (4 pc) were non-diagnostic. The only complication observed was dizziness in one patient. We conclude that FNA of the liver for the diagnosis of HCC is a safe, simple and accurate procedure which can be undertaken in settings that would otherwise not be suitable for formal liver biopsy.