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 […]
Anatomy and histology of the liver
Anatomy and histology of the liver The liver lobules are the structural and functional units of the liver. The lobule is surrounded by 6 portal tracts and centered on the centrolobular vein, which is a terminal twig of the hepatic vein. The portal vein ramifications in the portal tracts give off a series of branches […]
Bile duct hamartoma and adenoma
Bile duct hamartoma and adenoma The bile duct hamartoma (von Meyenberg complex) is characterized by multiple small nodules composed of haphazardly arranged bile ductules and fibrous stroma. The bile duct adenoma is a solitary, small subcapsular nodule. Cytologic diagnostic features Hypocellular specimens Benign ductal cells in tubules and cohesive sheets Benign hepatocytes
Fine needle aspiration (FNA)
Fine needle aspiration (FNA) Fine needle aspiration (FNA) is used mainly for the diagnosis of focal lesions of the liver, whereas percutaneous biopsy with a large-core needle is preferred for diagnosing diffuse liver diseases (such as hepatitis and cirrhosis), for which architectural details are important. Sensitivity of cytology is higher than the one of histology, […]
Hemangioma
Hemangioma It is the most common benign tumor of the liver. It is composed of dilated vascular spaces lined by endothelial cells. When a spindle cell lesion is observed on FNA, it is most likely a hemangioma. In some cases only blood or benign hepatocytes are observed. Cytologic diagnostic features Blood Hepatocytes Three-dimensional arcades of […]
Normal cells
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
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 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
Malignant tumors Hepatocellular carcinoma Cholangiocarcinoma (bile duct carcinoma) Hepatoblastoma Angiosarcoma Epithelioid hemangioendothelioma Metastatic tumors