[Ultrasound-guided fine-needle punctures of abdominal masses: cytology or histology? Comparative prospective study]

The aim of this study has been for one part to assess the obtaining of cytological and histological material from the same patients with the minimum amount of injections using a fine needle (diameter less than 1 mm) and also to evaluate the histological and cytological supply, individually and jointly in the diagnosis of abdominal tumors. Seventy lesions of which 58 hepatic have been punctured with fine needles of 20 (0.9 mm) to 22 G (0.7 mm). Material has been obtained in 98.6 per cent of cases for cytology and 54 per cent of cases for histology. Their respective sensitivity in the diagnosis of malignant tumors was 96.8 per cent and 86.8 per cent and was not improved by adjoint analysis. The specificity was 1 for cytology. The differential diagnosis in malignant hepatic tumors between hepatocarcinoma and metastasis was existent in 94.3 per cent of cases for cytology and 90 per cent for histology with no benefit coming from the association of two. In the group having hepatic metastasis without known primary cancer having found histological confirmation of the primary lesion, the cellular type has been revealed in exactitude in 94.4 per cent of cases with cytology and in 63.6 per cent with histology. No complications have been observed. The fine needle cytological aspiration ponction gives very satisfying results, comparable with regard to the diagnosis contribution to results of published studies, obtained with the use of coarse needle biopies. We suggest that fine needle ponction should be used preferentially and that coarse needle biopsy should be restricted to the few cases in which the former does not yield sufficient information.