Cytologic aspect of fibrolamellar hepatocellular carcinoma in fine-needle aspirates

Pérez‐Guillermo, Miguel; Masgrau, Nuria Alberti; García‐Solano, José; Sola-Pérez, Joaquín; Agustín, Pedro de

doi:10.1002/(sici)1097-0339(199909)21:3<180::aid-dc7>3.0.co;2-o

Cited by 54 publications

(18 citation statements)

References 19 publications

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“…[4–10] FNA specimens from these tumors generally show variably cellular smears with large, discohesive tumor cells with abundant granular and eosinophilic cytoplasm, centrally placed vesicular nuclei, prominent nucleoli and low nuclear to cytoplasmic ratios. The so-called “pale bodies” in the cytoplasm represent non-specific cytoplasmic invaginations.…”

Section: Discussionmentioning

confidence: 99%

“…[57] Intranuclear pseudoinclusions may be present and binucleation is not uncommon. [47] Bland, spindled cells arranged in parallel bands may also be seen, representing the bundles of collagen fibers and fibroblasts seen in the histologic sections. [4–10] The trabecular arrangement of conventional HCC is not seen.…”

Section: Discussionmentioning

confidence: 99%

“…[47] Bland, spindled cells arranged in parallel bands may also be seen, representing the bundles of collagen fibers and fibroblasts seen in the histologic sections. [4–10] The trabecular arrangement of conventional HCC is not seen. [410] Perez-Guillermo et al .…”

Section: Discussionmentioning

confidence: 99%

“…[4–10] The trabecular arrangement of conventional HCC is not seen. [410] Perez-Guillermo et al . described cytologic features of six cases of FL-HCC, and their morphometric studies showed that cell size, nuclear size and nucleolar size were significantly larger in FL-HCC cells than in those of conventional HCC.…”

Section: Discussionmentioning

confidence: 99%

“…[4–10] Diagnosis by FNA for this rare tumor, however, poses a unique set of challenges for unsuspecting pathologists, especially when this tumor is aspirated at unusual locations. We report here a unique case in which FL-HCC metastatic to the mediastinum was diagnosed by endoscopic ultrasound-guided FNA (EUS-FNA).…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of metastatic fibrolamellar hepatocellular carcinoma by endoscopic ultrasound-guided fine needle aspiration

et al. 2011

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The fibrolamellar variant of hepatocellular carcinoma (FL-HCC) is distinguished from other hepatocellular carcinomas (HCC) by its unique clinical and pathologic features. Cytological features for this tumor on fine needle aspiration (FNA) of primary tumors have been described earlier. We present here a unique case of metastatic FL-HCC diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of mediastinal adenopathy. A 32-year-old woman with a history of oral contraceptive use presented with nausea and severe abdominal pain but no ascites or stigmata of cirrhosis. She had a past history of resection of a liver lesion. Serial computed tomography scans revealed mediastinal lymphadenopathy and the patient was referred for endoscopic ultrasound (EUS). A transesophageal EUS-FNA was performed and tissue was collected for cytological evaluation by an on-site pathologist with no knowledge of prior history. Based on morphology correlated with prior history received later, a final diagnosis of metastatic FL-HCC in the retrocardiac lymph node was rendered on the EUS-FNA samples. There are very few reports in the literature where a diagnosis of FL-HCC is rendered at unusual sites. This case highlights that EUS-FNA is a relatively non-invasive, rapid, accurate and effective modality in obtaining tissue from otherwise hard-to-reach areas. It also suggests that metastasis of FL-HCC can be observed in mediastinal nodes and that diagnosis based on cytological features can be rendered even when the tumor is identified at unusual locations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis of metastatic fibrolamellar hepatocellular carcinoma by endoscopic ultrasound-guided fine needle aspiration

et al. 2011

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Outcome of patients with fibrolamellar hepatocellular carcinoma

Stipa¹,

Yoon

Liau

et al. 2006

Cancer

204

215

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BACKGROUNDFibrolamellar hepatocellular carcinoma (FL‐HCC) is a rare variant of hepatocellular carcinoma, has distinct pathologic features, and typically occurs in young patients without underlying hepatitis or cirrhosis.METHODSForty‐one patients with the pathologic diagnosis of FL‐HCC evaluated at our institution between 1986 and 2003 were identified from a prospective database.RESULTSMedian age of all patients was 27 years. None of these patients had underlying hepatitis or cirrhosis, and only 3 (7%) patients had an α‐fetoprotein level > 200 ng/mL. Twenty‐eight patients with primary disease underwent complete gross resection, and 13 patients were unresectable. In patients treated with resection, median tumor size was 9 cm (range, 3–17), 9 (36%) had vascular invasion, and 14 (50%) had lymph node metastases. There were no perioperative deaths. With a median follow‐up of 34 months, 5‐year overall survival for resected patients was 76%. However, 5‐year recurrence‐free survival was only 18%, and of the 9 resected patients with more than 5 years of follow‐up, 7 had recurrences. Lymph node metastasis was the only significant negative prognostic factor. Seventeen (61%) patients underwent a second operation for recurrent disease. Median survival for unresected patients with FL‐HCC was only 12 months, and no patient survived beyond 5 years.CONCLUSIONSFL‐HCC occurs in a distinctly different population of patients than common HCC, and patients with FL‐HCC generally fare better after complete resection. These tumors have a relatively indolent tumor biology, and late recurrences are common. Repeat resections for recurrence should be considered given the lack of other effective treatment options. Cancer 2006. © 2006 American Cancer Society.

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Fine‐needle aspiration cytology and differential diagnoses of fibrolamellar hepatocellular carcinoma metastatic to the mediastinum: Case report

Sarode

Castellani

Post

2002

Diagnostic Cytopathology

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We report a case of fibrolamellar hepatocellular carcinoma (FL-HCC) that metastasized to the posterior mediastinum. The diagnosis was made on fine-needle aspiration biopsy (FNAB). The cytologic features were characterized by the presence of large, dishesive, polygonal cells with granular cytoplasm and well-defined cell outlines resembling oncocytes. Groups of neoplastic hepatocytes containing bile pigment were also noted. The diagnosis of FL-HCC in a metastatic site can pose diagnostic challenges on FNAB. The cytologic features overlap with a variety of tumors that have oncocytic features and also with melanoma and paraganglioma. Recognition of specific cytologic features of FL-HCC can facilitate accurate diagnosis in a metastatic site. The cytologic findings and differential diagnoses of FL-HCC that metastasized to the posterior mediastinum are discussed.

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Cytologic aspect of fibrolamellar hepatocellular carcinoma in fine-needle aspirates

Cited by 54 publications

References 19 publications

Diagnosis of metastatic fibrolamellar hepatocellular carcinoma by endoscopic ultrasound-guided fine needle aspiration

Diagnosis of metastatic fibrolamellar hepatocellular carcinoma by endoscopic ultrasound-guided fine needle aspiration

Outcome of patients with fibrolamellar hepatocellular carcinoma

Fine‐needle aspiration cytology and differential diagnoses of fibrolamellar hepatocellular carcinoma metastatic to the mediastinum: Case report

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