[Ultrasound-guided thin-needle biopsy in focal liver diseases. I. Malignant hepatic tumors].

Eighty-six patients with focal liver disease underwent sonography-guided percutaneous fine needle biopsy for definitive diagnosis. Twenty-five out of twenty-six neoplastic liver tumors were correctly recognized as malignant. A sensitivity of 96% and a specificity of 98% (25 true positives, 60 true negatives, 1 false negative) was obtained. The high accuracy rate of this diagnostic procedure is explained by the precision of sonographic guidance and the copious excision of tissue material. In 57% of the malignant tumors, small tissue cylinders were obtained besides cytological material, which allowed a definitive tumor diagnosis in 11 out of 15 cases by histologic examination. In addition, the histologic evaluation of tissue fragments enables the differentation between primary and secondary hepatic malignomas. Because of the higher specificity of histological diagnosis, fine needle puncture of solid liver tumors should always provide tiny tissue cylinders for histologic examination.