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.

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