DIAGNOSTIC UTILITY OF FINE-NEEDLE ASPIRATION (FNA) CYTOLOGY IN THE MANAGEMENT OF LIVER DISEASE IN A DISTRICT HOSPITAL: An evaluation of 50 cases at Murang’a and Machakos District Hospitals in Kenya

Introduction: Fine-needle aspiration (FNA) cytology is a cost-effective technique of obtaining cellular specimens for diagnosis. It has many advantages over large needle core biopsies that make it quite suitable for out-patient departments and institutions without facilities for histopathologic diagnosis. Any site of the body can be sampled with FNA technique. Methods: Patients with liver disease visiting Murang’a and Machakos District Hospitals were identified for study. Focal lesions of the liver were aspirated using a 21 gauge fine-needle attached to a 10ml syringe. Thin smears of specimens were spread onto microscope slides and the slides dropped into 95% ethanol for 30 minutes. The smears were stained by the Papanicolaou stain and evaluated on the light microscope. Results: 21 of the 50 (42%) specimens had malignant cells; 15 of 50 (30%) specimens were necrotic; 2 of the 50 (4%) showed fatty change; 1 of 50 (2%) showed reactive cell changes later confirmed on histology to be cirrhosis; and 11 of 50 (22%) showed normal hepatocytes. Conclusions: The diagnostic utility of FNA cytology of the 50 patients with liver disease enabled diagnoses to be made for those patients. Clinical management options were based on the diagnoses made by fine-needle aspiration cytology. These results support the diagnostic utility of FNA cytology in the management of liver disease, especially in institutions without histopathology facilities.