Hepatocellular Carcinoma versus Other Carcinomas of Liver: Distinguishing Features

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

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

         

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