Cytomorphological Patterns of Nodular Lesions of Liver

Background and Objectives: Nodular lesions of liver are usually neoplastic (primary or metastatic), although inflammatory lesions can occur. The objectives of this paper were to study the cytomorphological changes in various nodular lesions of liver and to correlate the cytomorphological findings with biochemical parameters especially serum alpha-fetoprotein. Materials & Methods:  A cross-sectional study consisting of 40 patients with nodular liver lesions was carried out at Regional Institute of Medical Sciences (RIMS) during the period from August 2008 to July 2010 (2 years). A detailed clinical history and relevant data were collected. Fine needle aspiration cytology (FNAC) findings were correlated with clinical and biochemical parameters especially alpha-fetoprotein (AFP). Statistical analyses of the results were done and discussed. Results: Out of these 40 patients, 28 (70%) were male and 12 (30%) were female with a male female ratio of 2.3:1. Age of the patients ranged from 13 years to 85 years with a mean age of 47.5 yr. Regarding the FNAC diagnosis, 18 cases (45%) were non-neoplastic and 22 cases (55%) were neoplastic. Out of the total 22 malignant lesions, majorities were metastases with 14 cases (63.6%) and 8 cases (36.4%) were hepatocellular carcinoma (HCC). 75% of HCC patients (6 cases) had markedly elevated serum AFP level (> 500 ng/ml). The association of hepatic malignancy with serum alpha-fetoprotein level was found to be statistically significant. Conclusion: This study emphasized on unique cytomorphological patterns of distinctive liver lesions for the diagnosis by FNAC and importance of the interpretation of FNAC results along with serum alpha-fetoprotein level in the cases of malignancy