The strength of cytomorphology and efficacy of immuno‐cytochemistry in distinguishing hepatocellular carcinoma from its mimics on fine‐needle aspiration cytology

Chikhale, Mangesh; Toi, Pampa Ch; Siddaraju, Neelaiah; Ananthakrishnan, Ramesh

doi:10.1002/dc.24759

Cited by 3 publications

(1 citation statement)

References 45 publications

(108 reference statements)

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“…Hepatocellular carcinoma (HCC) metastasizes to the adrenal glands in ~10% of cases. 30,31 Metastatic HCC is hypercellular on FNA, composed of tumor cells present in 2-dimensional groups and trabecular arrangements (Fig. 6C).…”

Section: Metastatic Malignancy Versus Adrenal Cortical Neoplasmsmentioning

confidence: 99%

Approach to Fine Needle Aspiration of Adrenal Gland Lesions

Cantley¹

2022

Advances in Anatomic Pathology

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Adrenal gland lesions are present in 1% to 5% of patients and are most commonly identified incidentally on abdominal imaging. Fine needle aspiration (FNA) cytology plays an important role in the initial workup of adrenal gland nodules, especially in patients with a known history of malignancy. The most common reason for adrenal gland FNA is to differentiate benign adrenal lesions, such as adrenal cortical adenoma, from metastatic malignancy. However, there is a significant cytomorphologic overlap between primary and metastatic adrenal neoplasms. This review focuses on the current state of adrenal gland FNA cytology, with an emphasis on distinguishing adrenocortical adenoma from carcinoma and adrenal cortical neoplasms from metastatic malignancies. The role of immunohistochemistry in specifically diagnosing adrenal neoplasms is discussed. Proposed diagnostic classification systems for adrenal gland FNA cytology are also described.

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Section: Metastatic Malignancy Versus Adrenal Cortical Neoplasmsmentioning

confidence: 99%

Approach to Fine Needle Aspiration of Adrenal Gland Lesions

Cantley¹

2022

Advances in Anatomic Pathology

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The utility of next‐generation sequencing in challenging liver FNA biopsies

Balitzer,

Greenland

2024

Cancer Cytopathology

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BackgroundFine‐needle aspiration (FNA) biopsy is increasingly used for the diagnosis of hepatocellular masses. Because distinguishing well differentiated hepatocellular carcinoma (HCC) from other well differentiated hepatocellular lesions (e.g., large regenerative nodules or focal nodular hyperplasia) requires an assessment of architectural features, this may be challenging on FNA when intact tissue fragments are not sampled. Poorly differentiated HCC and intrahepatic cholangiocarcinoma (ICC) may exhibit overlapping pathologic features. Molecular testing can be helpful, because mutations in TERT promoter and CTNNB1 (β‐catenin) are characteristic of HCC, whereas mutations in BAP1, IDH1/IDH2, and PBRM1 may favor ICC. The goal of this study was to assess the role of next‐generation sequencing (NGS) in further subclassifying indeterminate liver lesions sampled by FNA.MethodsA retrospective review of liver cytology cases with NGS on cell block material was performed. Age, radiologic features, background hepatic disease and treatment, outcome, and NGS data were obtained from the electronic medical record.ResultsTwelve FNA biopsies that had cell blocks from clinically suspected primary hepatic masses were identified. The presence of a TERT promoter mutation supported a diagnosis of HCC for one well differentiated neoplasm. For three patients, the presence of mutations, such as IDH1, CDKN2A/CDKN2B, and BRAF, supported a diagnosis of ICC. Of the eight poorly differentiated carcinomas, NGS helped refine the diagnosis in six of eight cases, with one HCC, three ICCs, and two that had combined HCC‐ICC, with two cases remaining unclassified.ConclusionsMolecular diagnostics can be helpful to distinguish HCC and ICC on FNA specimens, although a subset of primary hepatic tumors may remain unclassifiable.

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The Complementary Role of PET to Pathology in Differentiating the Primary Origin of a Malignant Skin Nodule from Liver or Lung

Chen

Yip

et al. 2022

Nucl Med Mol Imaging

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The strength of cytomorphology and efficacy of immuno‐cytochemistry in distinguishing hepatocellular carcinoma from its mimics on fine‐needle aspiration cytology

Cited by 3 publications

References 45 publications

Approach to Fine Needle Aspiration of Adrenal Gland Lesions

Approach to Fine Needle Aspiration of Adrenal Gland Lesions

The utility of next‐generation sequencing in challenging liver FNA biopsies

The Complementary Role of PET to Pathology in Differentiating the Primary Origin of a Malignant Skin Nodule from Liver or Lung

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