Is FNA safe for all liver masses

Is FNA safe for all liver masses

Is FNA or core biopsy safe or necessary for all hepatic masses? 

• Benign masses such as hemangiomas, focal nodular hyperplasia, and adenomas often have distinguishing characteristics on high-quality cross-sectional imaging modalities.
• When these masses are present in patients with classic corresponding clinical features, obtaining specimens for cytologic or histologic examination is usually not necessary.
• If any imaging or clinical features are not characteristic, biopsy can be performed safely.
• Carcinoid crisis characterized by profound hypotension can be precipitated by FNA of hepatic carcinoid metastases.
• Patients with carcinoid tumors typically present with characteristic clinical symptoms and can be confirmed biochemically.
• If biopsy of a suspected hepatic carcinoid metastasis must be performed for diagnosis, appropriate preparatory measures should be taken and resuscitative equipment needs to be readily available.