Cytohistologic diagnosis of neoplasms of the liver by ultrasonically guided fine-needle aspiration biopsy.

A procedure was developed for obtaining both cytologic and histologic specimens from patients suspected of having hepatic malignancy at the time of ultrasonically guided liver aspiration biopsy using a 22-gauge needle of 0.4 mm inner diameter. The fine needle and the syringe used were heparinized before use to avoid blood coagulation in the materials obtained. With heparinized needle and syringe it was possible to centrifuge the materials obtained and make good smears containing abundant tumor cells, and to obtain small tissue specimens. Histologic specimens obtained with the heparinized needle were fixed in 2.5% glutaraldehyde, postfixed in 1.0% osmium tetroxide, and embedded in epoxy Epon resin. Ultrathin sections were made and usually stained with Azan-Mallory stain. In 41 patients suspected of having hepatic malignancy, a correct diagnosis was made by a combination of these examinations. The sensitivity of this procedure for hepatic malignancy was 100%, and the specificity was 95.7%. Therefore, this procedure is a very reliable method for diagnosis of hepatic malignancy.