Benign clear cell tumor (‘sugar’ tumor) It is a rare tumor, occurring in any age as an asymptomatic peripheral nodule. Because of their immunohistochemical and ultrastructural features, they have been supposed to origin from pericytes; anyway, their origin is a matter of discussion. They consist of polygonal cells with clear, glycogen-rich cytoplasm. Cytologic diagnostic features […]
Epithelioid hemangioendothelioma Hypocellular (in some cases) Isolated, large polymorphous cells with a folded nuclear outline Occasional intranuclear and cytoplasmic inclusions Binucleated and multinucleated giant cells Round irregular nuclei, prominent nucleoli Abundant lacy and hematoxiphilic cytoplasm Immunostains for endothelial markers are usually positive.
Metastatic tumors Colorectal carcinoma Tall (columnar), dark (hyperchromatic) cells and necrosis Breast carcinoma and gastric carcinoma Sig net rin g cells Prostate carcinoma Mic roacini Prominent nucleoli Immu noreactive for Prostatic Specific Antigen and Prostatic Acid Phosphatase Well-differentiated neuroendocrine tumors Eccen trically placed nuclei salt-and-pepper chromatin pattern Abundant granular cytoplasm Single cells, loosely cohesive clusters and rosettes Immunore active for neuroendocrine […]
Normal cells Normal cells are commonly seen in the cytologic specimens of the liver. Hepatocytes, bile duct epithelium, Kupffer cells and sheets of mesothelial cells are often observed in the cytologic preparations. Hepatocytes – cytologic features Large polygonal cells Isolated cells, thin ribbons (trabeculae), or larger tissue fragments Centrally placed, round to oval nuclei, binucleation, […]
Angiomyolipoma This benign tumor occurs most commonly in the kidney, but it may be seen in other locations as well, including the liver. The average age of the patients is about 50 years; some of them have tuberous sclerosis. Many of these tumors are not biopsied because they can be identified by imaging studies. Cytologic […]
Infections Infections by the hepatotropic viruses (hepatitis A, B and C) are usually not evaluated by FNA because the diagnostic changes are primarily architectural. Focal lesions of the liver may result from a hepatic abscess or an echinococcal cyst.
Malignant tumors Hepatocellular carcinoma Cholangiocarcinoma (bile duct carcinoma) Hepatoblastoma Angiosarcoma Epithelioid hemangioendothelioma Metastatic tumors
Hepatic abscess Hepatic abscesses can be bacterial, fungal or amebic (due to Entamoeba histolytica). Bacterial abscesses result from ascending cholangitis and sepsis. Fungal abscesses (such as those due to Candida species) are most common in immunocompromised patients. Cytologic diagnostic features Abundant polymorphonuclear leukocytes and necrotic debris Possibly bacteria and fungi in routine stains, but special […]
Hepatocellular carcinoma (HCC) Hepatocellular carcinoma (HCC) accounts for 90% of all primary cancers of the liver. It is more common in Africa and Asia than in United States and Europe, where most cases are seen in the setting of cirrhosis. Most patients are over 50 years old. The tumor can present as a solitary nodule, […]
Echinococcal cyst (hydatid cyst) The larval form of Echinococcus granulosus, a dog tapeworm, causes infections in many organs, mainly the liver. Imaging studies reveal a solitary cyst, often with a fluid level. An outer, acellular, laminated membrane lines the cyst. The internal, germinal layer gives rise to daughter cysts, each of which containing scolices with […]