Fine needle aspiration biopsy of hepatocellular carcinoma. Some unusual features
Wee, A.; Nilsson, B.; Chan-Wilde, C.; Yap, I.
Acta Cytologica 35(6): 661-670
1991
ISSN/ISBN: 0001-5547 PMID: 1659093 Document Number: 372647
The cytologic features of fine needle aspiration smears from 28 hepatocellular carcinomas (HCC) were reviewed. All aspirations except one were guided. There were 14 well-, 11 moderately and 3 poorly differentiated HCC. The better-differentiated HCC were characterized by similarity of the tumor cells to hepatocytes (83%), cohesive cell clusters with a trabecular arrangement (72%) and presence of sinusoidal endothelial cells (66%). Other features included bile production (38%), atypical hepatocytic naked nuclei (52%), acinar formation (31%), intracytoplasmic vacuoles (14%) and abnormal vascular patterns (14%). Poorly differentiated HCC showed dyshesive pleomorphic cells. Unusual cytologic features from a well-differentiated HCC with fatty change and an HCC with a prominent acinar component are described. The identification of fatty change in dissociated well-differentiated hepatocytes or cytologic features suggestive of an adenocaricnoma do not preclude the diagnosis of HCC. The usefulness of cell blocks is emphasized.