• Xiaoqi LinEmail author
  • Brandon A. Umphress
  • Ernest F. WigginsIII
  • Ramona Gupta
  • Albert A. NemcekJr.


The main indication for fine-needle aspiration (FNA) biopsy of the liver is the diagnosis of localized disease by imaging studies, including hepatocellular carcinoma (HCC) and metastatic neoplasms from either a known or unknown primary tumor. The overall sensitivity, specificity, and accuracy of FNA in the diagnosis of malignant lesions is 92% to 96%, 92% to 100%, and 96%, respectively. Sensitivity of FNA to differentiate HCC from metastatic tumors in the liver is approximately 96%, with a specificity of 100% and a diagnostic accuracy of 97.5%. FNA of benign liver lesions poses an increased diagnostic challenge. Aspiration of cystic lesions, which is less frequently performed, can help in detecting a possible neoplastic origin of the cyst or accompanying microorganisms. As imaging studies have improved, FNA has become less useful for diagnosis of hepatitis and cirrhosis. Moreover, differentiation between cirrhosis and benign hepatocellular lesions (i.e., regenerative nodules) by FNA remains difficult.


Liver Liver cytopathology Liver radiology Liver histopathology Hepatology 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Xiaoqi Lin
    • 1
    Email author
  • Brandon A. Umphress
    • 2
  • Ernest F. WigginsIII
    • 3
  • Ramona Gupta
    • 4
  • Albert A. NemcekJr.
    • 4
  1. 1.Northwestern University, Feinberg School of Medicine, Northwestern Memorial HospitalChicagoUSA
  2. 2.Department of PathologyNorthwestern Memorial Hospital, McGaw Medical CenterChicagoUSA
  3. 3.Department of RadiologyMonmouth Medical CenterShrewsburyUSA
  4. 4.Northwestern University Feinberg School of MedicineChicagoUSA

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