Blind or US-guided FNAB may be the practice, often for Gamma-secretase inhibitor advanced disease. Practising under such circumstances requires a high level of basic diagnostic skill without the crutch of fancy ancillary tests. A diagnostic algorithm based on generic pattern recognition

cum cell profiling to map out the possible liver mass lesions, benign/malignant, solid/cystic, primary/secondary, would be of great help (20,21). The authors stress the importance Inhibitors,research,lifescience,medical of integrative clinicopathologic and radiologic correlation for the final diagnosis of liver mass lesions. This review is suitable reading for general non-cytopathology community. It enlightens them on the similarities of some liver conditions and the difficulties faced by cytopathologists in addressing small tissue samples of mass lesion from an organ as complex and diverse as the Inhibitors,research,lifescience,medical liver. The diagnostic tribulations are accentuated in the

absence of diagnostic aids, such as immunohistochemistry. Acknowledgements Disclosure: The author declares no conflict of interest.
The main indication for fine needle aspiration Inhibitors,research,lifescience,medical (FNA) of the liver is in the diagnosis of focal mass lesions. This includes both primary as well as metastatic neoplasms. Blind percutaneous biopsy with a large core needle is the preferred method for evaluating diffuse liver diseases (hepatitis, cirrhosis) where architectural details are important. FNA is not useful in identifying Inhibitors,research,lifescience,medical diffuse liver disorders such as hepatitis or cirrhosis, but may be employed to rule out neoplasms from the differential diagnosis when inflammatory or diffuse liver diseases appear to be non-homogenous or mimic mass-like lesions on radiology. The definition of FNA is arbitrarily defined as that performed with needles of 1mm diameter or less, so practically any needles smaller than 19 G. FNA is usually performed percutaneously via abdominal/lower thoracic wall with a 22-23 G needle, 80-150 mm in length, Inhibitors,research,lifescience,medical under CT or ultrasound

guidance, or EUS for smaller masses. Blind needle aspirates may be performed for large palpable masses (1). FNA is a rapid, safe and extremely cost effective method for diagnosis. Studies have shown FNA to be more sensitive (81-93.5%) and specific technique Idoxuridine for diagnosing malignancy than conventional biopsy in experienced hands (2,3). The smaller diameter of the needle allows more extensive and multiple samples to be obtained; any region of the liver, including lesions in the left lobe and the porta hepatis may be sampled (which is too risky to perform using large bore needles). Multiple samples are easy to obtain, allowing for greater sampling. All portions of the liver can be safely sampled. Sensitivity and specificity of malignant diagnoses are high. False positive diagnoses are uncommon (4).