Category Archives: 3(1) Jan-June 2005

Hepatocellular Carcinoma versus Other Carcinomas of Liver: Distinguishing Features

Anwar Ul Haque, Aliya Sani and Nuzhat Sultana
Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad.
Objective: To find out the helpful cytological features distinguishing between hepatocellular carcinoma (HCC) with other
carcinomas of liver Study Design: Fine Needle Aspiration Cytology (FNAC) cases were selected in 35 patients on whom a diagnosis was rendered either of hepatocellular carcinoma or other carcinoma involving liver. The aspirates were examined for slide background, cellularity and specific cytoplasmic and nuclear features in both sets.
Result: There were 20 cases of hepatocellular carcinoma (HCC) & 12 cases of other carcinoma involving liver. Six out of twelve In the current study we examined 12 cytological criteria out of which six were found to be of considerable help in distinguishing hepatocellular carcinoma (HCC) from other carcinoma involving liver. The hepatocellular carcinomas characteristically had central nuclei, discohesive cells, high cellularity and naked nuclei while hyperchromatic nuclei, eccentric nuclei and nuclear cytoplasmic ratio of >75% were the prominent features of other carcinoma involving liver. On the other hand coarse chromatin, nuclear molding and chromatin clearing of nuclei showed no significant difference in
distinguishing hepatocellular carcinoma from other primary and metastatic carcinoma of the liver.
Conclusion: Fine needle aspiration cytology (FNAC) of the liver is a very useful diagnostic modality to identify the vast majority of neoplasms of primary or metastatic nature. Meticulous attention to the nuclear features is vital in distinguishing hepatocellular carcinoma (HCC ) from other carcinomas of liver.
Keywords: Hepatocellular carcinoma, HCC, FNAC of liver, other carcinomas of liver and metastatic carcinomas of liver

A Comparative Study of Various Needle Gauges in Diagnostic Fine Needle Aspiration Cytology

Anwar Ul Haque and Ambreen Moatasim
Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad.
Objective: To compare various needle gauges (23, 24 and 29) in diagnostic accuracy in aspiration of cytology.
Design: A comparative- cross-sectional study.
Setting: Islamabad Institute of Pathology & Pakistan institute of medical sciences, Islamabad
Subjects: 33 cases with six Fine Needle aspiration Cytology (FNAC) aspirates on each; two each by using 23, 24 butterfly
needle and 29 gauge insulin syringe needles
Results: With 23-gauge needle, definite diagnosis without any difficulty was reached in 16 (48.5%) cases, a definite
diagnosis with some difficulty in 10 (30.3%) cases, a probable diagnosis in 4 (12.1%) and no definite diagnosis in 3 (9.1%)
cases. With 24- gauge butterfly needle definitive diagnosis reached in 12 (36.4%), a definite but difficult diagnosis in
14(42.4%), probable in 3 (9.1%), and no diagnosis in 4 (12.1%). Finally, with 29- gauge a definite diagnosis was possible in
18 (54.5%) cases while there were 5 (15%) cases each. in all other categories i.e. definite but with some difficulty, probable
and no diagnosis. The P-value was .377
Conclusion: There was no statistical difference among various gauge needles. Since the finer needle the needle better it is,
the thinnest needle i.e. 29-gauge needle seems to be the most appropriate needle for routine use in superficially located
masses.