FINE-NEEDLE ASPIRATION BIOPSY OF PORTAL-VEIN THROMBUS - VALUE IN DETECTING MALIGNANT THROMBOSIS

OBJECTIVE. The purpose of this study was to assess the usefulness of fine-needle aspiration biopsy of portal vein thrombus to identify or exclude tumor. SUBJECTS AND METHODS. A series of 18 consecutive patients with portal vein thrombosis underwent fine-needle aspiration biopsy of the thrombus. Sixteen had underlying cirrhosis. Fifteen had clinical, biochemical, and imaging evidence of neoplastic invasion of the vein. Two patients had metastatic involvement of the left lobe of the liver, and the others had multinodular (eight cases) or diffuse (five cases) hepatocellular carcinoma. In four cases, the tumor was not clearly identified at sonography. RESULTS. Aspiration biopsy was positive for malignant tumor in 14 cases and negative for malignancy in one. In the three patients with benign portal vein thrombosis, fine-needle aspiration biopsy yielded only hepatocytes, fibrin, and blood cells. No results were false-positive. No complications were detected. CONCLUSION. Fine-needle aspiration biopsy is safe and sensitive for establishing the benign or malignant nature of portal vein thrombosis. This technique may be useful in selecting patients for liver transplantation.