Cell features and patterns in fine-needle aspirates of hepatocellular carcinoma

Abstract

The values of the cytologic features of individual cells and cellular patterns in aspirated materials in the diagnosis of 49 hepatocellular carcinomas (HCC) were investigated. Excellent cytologic specimens were obtained by percutaneous aspiration biopsy with a heparinized fine 22-gauge needle. In the well-differentiated type of HCC, a correct diagnosis of malignancy was difficult from the cytologic features of individual cells because of their resemblance to normal hepatocytes. In contrast, in moderately differentiated and poorly differentiated types of HCC, a correct diagnosis of malignancy was easily made from the features of individual cells, but there was little or no cytologic evidence of the hepatic origin of the cells. Comparison of histologic and cytologic findings in aspirated materials obtained from the same patients showed that the cellular patterns seen in cytologic specimens faithfully reflected the histologic structures of HCC. Various characteristic cellular patterns were recognized only in specimens obtained from patients with HCC, but not in those from patients with benign liver diseases. These cellular patterns were very useful not only for diagnosis of malignancy, but also for identification of the hepatic origin of cells. A combination of the features of individual cells and of characteristic cellular patterns raised the diagnostic rates for well-, moderately, and poorly differentiated types of HCC to 90.5%, 100%, and 100%, respectively.

Cytomorphological variables of hepatic malignancies in fine needle aspiration smears with special reference to grading of hepatocellular carcinoma

“…Cellular patterns observed in aspirated material useful for the diagnosis of HCC include either trabecular or acinar arrangement of cells, high cellularity of smears, polygonal cells with central nuclei, abundant granular cytoplasm, coarse granular chromatin, increased nucleocytoplasmic ratio, malignant cells separated by sinusoidal endothelial cells, presence of bile, prominent nucleoli, multinucleated tumor giant cells, atypical stripped nuclei, large and small cytoplasmic vacuoles, intracytoplasmic and intranuclear inclusions[121314] [Table 3]. …”

HURP Expression-Assisted Risk Scores Identify Prognosis Distinguishable Subgroups in Early Stage Liver Cancer

“…The air-dried smears were immediately stained with Riu's method [24]. Grading of HCC was made by Edmondson and Steiner's classification [25].…”

Solid Focal Liver Lesions: Dynamic and Late Enhancement Patterns with the Dual Phase Contrast Agent Gadobenate Dimeglumine

“…During the arterial phase after gadobenate dimeglumine administration (c) a marked nodular enhancement can be observed with a rapid washout during the portal venous phase (d). On the hepatobiliary phase image after gadobenate dimeglumine administration (e), NRH lesions are homogenously, slightly hyperintense, reflecting the presence of functioning hepatocytes with abnormal biliary system drainage material), fibrosis, necrosis and amorphous calcifications [33]. Vascular invasion of intrahepatic and perihepatic vessels is also comparatively common.…”

“…Gradually increasing enhancement over time is found in poorly differentiated scirrhous lesions, whereas minimal or no contrast enhancement is seen in small, well-differentiated neoplasms. Sometimes a mixture of variable-differentiated areas may be found in large HCC lesions [31][32][33][34]. Fig.…”