Hepatic abscess
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) 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)
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 […]
Cholangiocarcinoma (bile duct carcinoma)
Cholangiocarcinoma (bile duct carcinoma) Cholangiocarcinoma is much less common than HCC and not associated with cirrhosis. It arises from intrahepatic and extrahepatic bile ducts. The diagnosis can be made by bile cytology, brush cytology or percutaneous FNA. Cytologic diagnostic features Isolated cells, crowded sheets and cell clusters, some in acinar arrangements Nuclear enlargement and pleomorphism […]
Hepatoblastoma
Hepatoblastoma It is a rare tumor of infancy. Cytologic smears mimic those from HCC, with larger and more anaplastic cells, or those from small, blue, round cells tumors of childhood.
Solitary cysts
Solitary cysts The simple, unilocular cyst is lined by cuboidal or columnar epithelium resembling biliary epithelium. The aspirated fluid is typically hypocellular and non-diagnostic. The ciliated foregut cyst is unilocular and lined by respiratory-type epithelium. Ciliated columnar cells and mucus cells are seen in cytologic specimens. This benign lesion must be differentiated from bile duct […]
Angiosarcoma
Angiosarcoma It is an uncommon malignant tumor (less than 1% of primary liver malignancies). It is associated with cirrhosis in about one-third of the cases. Many patients have been exposed to polyvinyl chloride or to Thorotrast as a a radiographic contrast agent. Cytologic diagnostic features Elongated cells, isolated or in tightly cohesive clusters and syncitia […]
Cirrhosis
Cirrhosis Cirrhosis, whether caused by alcoholic hepatitis, viral hepatitis or other diseases, results in a disruption of the normal liver architecture, with bands of fibrosis separating nodules of regenerating hepatocytes. Some nodules can be larger and raise the suspicious of a malignancy, such as hepatocellular carcinoma. As a matter of fact, patients with cirrhosis are […]
Focal nodular hyperplasia
Focal nodular hyperplasia It is a benign lesion, presenting as a solitary nodule or, less commonly, as several nodules. Most patients are women in their third or fourth decade. The lesions usually have a central scar and are composed of nodules of hepatocytes, which are separated from one another by radiating fibrous septae containing bile […]
Liver cell adenoma
Liver cell adenoma It is an uncommon benign tumor, usually occurring in women under the age of 30 who have a history of use of oral contraceptives. Histologically, they are only composed of hepatocytes. Cytologic diagnostic features Predominance of hepatocytes Mild nuclear atypia Abundant cytoplasm Normal N/C ratio Differential diagnosis Normal liver Focal nodular hyperplasia […]