Diagnostic role of cell block in ultra sound guided fine needle aspiration cytology of focal liver lesions

مقدم أطروحة جامعية

al-Sadiq, Shawqi Abd al-Rahman

مشرف أطروحة جامعية

Muhammad, Ahmad Abd al-Badi
al-Mubarak, Ahmad Umar

الجامعة

جامعة أم درمان الإسلامية

الكلية

كلية المختبرات الطبية

دولة الجامعة

السودان

الدرجة العلمية

دكتوراه

تاريخ الدرجة العلمية

2012

الملخص الإنجليزي

Background : The evaluation and management of various hepatic lesions is acommon clinical problem and their appreciate clinical management depends on accurate diagnosis. Design : This is a prospective cross-sectional study. Objective : The study aimed to assess the diagnostic role of cell block and ultrasound guided FNAC in diagnosis of liver lesions Methods : This study was conducted in Khartoum state during the period of November 2008 to November 2011.

One hundred and five cytological materials were collected from patients with liver lesions using US–guided FNAC.

All smears stained by Papanicolaou and diff Quick stains, the residual material were mixed with formalin in order to prepare paraffin–embedded block, from each block 4 slides were taken, one was stained by H & E and the remaining three slides were stained by avidin / biotin complex (ABC) procedure for immunohistochemical expression of CK, AFP and HepPar-1 markers. Results : The age of the selected patients ranged from 5years to > 60.

Males were 64(61 %) and females were 41(39 %).

The cytological smears results were as follows Malignant 72.4 %, benign lesions 17.1%, bloody sample and normal hepatocyte 10.5 %, while the diagnosis by cell block was found to be as follows ; Malignant 39 %, benign lesion 24.8 %, bloody sample 27.6 %, normal hepatocytes 3.8 % and deficient samples were 4.8% (in which no cells detected).

Samples diagnosed as hepatocellular carcinoma (HCC) were 31 samples, of these 25 (80.6 %) were positive for CK, 24 (77.4 %) were positive for AFP and 20 (64.5 %) were positive for HepPar1. The samples diagnosed as metastatic adenocarcinoma were found to be 9 cases, all were positive for CK, 6 (66.6 %) were positive for AFP and 2 samples (22.2 %) samples were positive for HepPar1. Twenty six (24.7 %) of the cases were diagnosed as benign lesions, including (liver abscess, inflammatory reaction and liver cirrhosis).

The positivity of CK, AFP and HepPar1 was found to be 16 (61.5 %), 9 (34.6 %) and 3 (11.5 %) respectively. One case was diagnosed as hepatoblastoma and it was found to be positive for the three selected markers.

Bloody samples were found to be 29 (27.6%) samples, CK was detected in 2 (6.8 %), AFP 1(3.4 %), all were negative for HepPar1. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the cytology were 100 %, 63.3 %, 78.8 % and 46.3 respectively. Conclusion : FNAC with ultrasound guidance of liver lesions is an effective procedure for diagnosing malignancy.

However, cytological examination alone may fail to pinpoint the type of the tumor.

Concomitant examination of cell block not only confirms the malignancy but also helps in sub typing it.

Recommendation : We recommended the use of cell block technique as an adjunct technique to FNAC for diagnosis of liver lesions.

التخصصات الرئيسية

الطب البشري

الموضوعات

• الكبد
• التشخيص

عدد الصفحات

76

قائمة المحتويات

• APA
• MLA
• AMA

لغة النص

الإنجليزية

نوع البيانات

رسائل جامعية

رقم السجل

BIM-364651