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Liver Cytology

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Atlas of Non-Gynecologic Cytology

Part of the book series: Atlas of Anatomic Pathology ((AAP))

Abstract

Although there have been many advancements in imaging techniques for the diagnosis of benign and malignant liver lesions, obtaining tissue for morphologic and molecular characterization is critical for diagnosis and treatment. Fine needle aspiration (FNA) and needle core biopsy are the most commonly used procedures for the morphological evaluation of liver lesions because of their decreased rates of procedural complications compared with open and more invasive approaches. These procedures are usually performed in an outpatient setting under the guidance of ultrasound or CT. This chapter summarizes the key findings for the accurate morphological diagnosis of benign, malignant, and metastatic lesions of the liver.

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References

  1. Xue Y, Farris AB, Quigley B, Krasinskas A. The impact of new technologic and molecular advances in the daily practice of gastrointestinal and hepatobiliary pathology. Arch Pathol Lab Med. 2017;141:517–27.

    Article  PubMed  Google Scholar 

  2. Srinivasan I, Tang SJ, Vilmann AS, Menachery J, Vilmann P. Hepatic applications of endoscopic ultrasound: Current status and future directions. World J Gastroenterol. 2015;21:12544–57.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sadeghi A, Mohamadnejad M, Islami F, Keshtkar A, Biglari M, Malekzadeh R, Eloubeidi MA. Diagnostic yield of EUS-guided FNA for malignant biliary stricture: a systematic review and meta-analysis. Gastrointest Endosc. 2016;83:290–8.

    Article  PubMed  Google Scholar 

  4. Koduru P, Suzuki R, Lakhtakia S, Ramchandani M, Makmun D, Bhutani MS. Role of endoscopic ultrasound in diagnosis and management of hepatocellular carcinoma. J Hepatocell Carcinoma. 2015;2:143–9.

    PubMed  PubMed Central  Google Scholar 

  5. Crowe DR, Eloubeidi MA, Chhieng DC, Jhala NC, Jhala D, Eltoum IA. Fine-needle aspiration biopsy of hepatic lesions: computerized tomographic-guided versus endoscopic ultrasound-guided FNA. Cancer. 2006;108:180–5.

    Article  PubMed  Google Scholar 

  6. Onofre AS, Pomjanski N, Buckstegge B, Böcking A. Immunocytochemical diagnosis of hepatocellular carcinoma and identification of carcinomas of unknown primary metastatic to the liver on fine-needle aspiration cytologies. Cancer Cytopathol. 2007;111:259–68.

    Article  CAS  Google Scholar 

  7. Cibas ES. Peritoneal washings. In: Cibas ES, Ducatman BS, editors. Cytology: diagnostic principles and clinical correlates. Philadelphia: Saunders/Elsevier; 2014. p. 155–70.

    Google Scholar 

  8. Dodd LG, Mooney EE, Layfield LJ, Nelson RC. Fine-needle aspiration of the liver and pancreas: a cytology primer for radiologists. Radiology. 1997;203:1–9.

    Article  CAS  PubMed  Google Scholar 

  9. Ljung BM, Ferrell LD. Fine-needle aspiration biopsy of the liver: diagnostic problems. Pathology (Phila). 1996;4:365–88.

    CAS  Google Scholar 

  10. Hammoud GM, Almashhrawi A, Ibdah JA. Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions. World J Gastrointest Oncol. 2014;6:420–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jones K, Biederman L, Draganova-Tacheva R, Solomides C, Bibbo M. Diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration cytology of porta hepatis lesions: a retrospective study. Acta Cytol. 2016;60:154–60.

    Article  CAS  PubMed  Google Scholar 

  12. Wee A. Fine needle aspiration biopsy of hepatocellular carcinoma and hepatocellular nodular lesions: role, controversies and approach to diagnosis. Cytopathology. 2011;22:287–305.

    Article  CAS  PubMed  Google Scholar 

  13. Chaudhary HB, Bhanot P, Logroño R. Phenotypic diversity of intrahepatic and extrahepatic cholangiocarcinoma on aspiration cytology and core needle biopsy. Cancer Cytopathol. 2005;105:220–8.

    Article  Google Scholar 

  14. VandenBussche C, Gocke CD, Li QK. Fine needle aspiration of metastatic papillary thyroid carcinoma found in the liver. Diagn Cytopathol. 2013;41:418–24.

    Article  PubMed  Google Scholar 

  15. Balani S, Malik R, Malik R, Kapoor N. Cytomorphological variables of hepatic malignancies in fine needle aspiration smears with special reference to grading of hepatocellular carcinoma. J Cytol. 2013;30:116–20.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Geramizadeh B, Asadi N, Tabei SZ. Cytologic comparison between malignant and regenerative nodules in the background of cirrhosis. Hepat Mon. 2012;12:448–52.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bibbo M, Wood MD, Fitzpatrick BT. Peritoneal washings and ovary. In: Bibbo M, Wilbur D, editors. Comprehensive cytopathology. 3rd ed. Philadelphia: Saunders/Elsevier; 2008. p. 291–302.

    Chapter  Google Scholar 

  18. DeMay RM. The art and science of cytopathology, exfoliative cytology, vol. 1. 2nd ed. Chicago: ASCP Press; 2012.

    Google Scholar 

  19. Lev-Toaff AS, Bach AM, Wechsler RJ, Hilpert PL, Gatalica Z, Rubin R. The radiologic and pathologic spectrum of biliary hamartomas. AJR Am J Roentgenol. 1995;165:309–13.

    Article  CAS  PubMed  Google Scholar 

  20. Mortele KJ, Ros PR. Benign liver neoplasms. Clin Liver Dis. 2002;6:119–45.

    Article  PubMed  Google Scholar 

  21. Salles VJ, Marotta A, Netto JM, Speranzini MB, Martins MR. Bile duct hamartomas—the von Meyenburg complex. Hepatobiliary Pancreat Dis Int. 2007;6:108–9.

    PubMed  Google Scholar 

  22. Ghouri YA, Mian I, Rowe JH. Review of hepatocellular carcinoma: Epidemiology, etiology, and carcinogenesis. J Carcinog. 2017;16:1. https://doi.org/10.4103/jcar.JCar_9_16.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Ma C, Zhang Q, Greten TF. Nonalcoholic fatty liver disease promotes hepatocellular carcinoma through direct and indirect effects on hepatocytes. FEBS J. 2017;285:752–62. https://doi.org/10.1111/febs.14209.

    Article  PubMed  CAS  Google Scholar 

  24. Sheikh U, Rodic N, Maleki Z. Extramedullary hematopoiesis: cytomorphologic, histologic, and radiologic findings in sixteen cases. Acta Cytol. 2015;59:144–8.

    Article  CAS  PubMed  Google Scholar 

  25. Naganuma H, Ishida H, Ogawa M, Watanabe Y, Watanabe D, Ohyama Y, Watanabe T. Focal nodular hyperplasia: our experience of 53 Japanese cases. J Med Ultrason (2001). 2017;44:79–88.

    Article  Google Scholar 

  26. Burgio MD, Ronot M, Salvaggio G, Vilgrain V, Brancatelli G. Imaging of hepatic focal nodular hyperplasia: pictorial review and diagnostic strategy. Semin Ultrasound CT MR. 2016;37:511–24.

    Article  Google Scholar 

  27. Doolittle DA, Atwell TD, Sanchez W, Mounajjed T, Hough DM, Schmit GD, Kurup AN. Safety and outcomes of percutaneous biopsy of 61 hepatic adenomas. AJR Am J Roentgenol. 2016;206:871–6.

    Article  PubMed  Google Scholar 

  28. Bioulac-Sage P, Sempoux C, Balabaud C. Hepatocellular adenomas: morphology and genomics. Gastroenterol Clin North Am. 2017;46:253–72.

    Article  PubMed  Google Scholar 

  29. Nault JC, Couchy G, Balabaud C, Morcrette G, Caruso S, Blanc JF, et al.; GENTHEP Investigators. Molecular classification of hepatocellular adenoma associates with risk factors, bleeding, and malignant transformation. Gastroenterology. 2017;152:880–94.

    Article  CAS  PubMed  Google Scholar 

  30. VandenBussche CJ, Wakely PE Jr, Siddiqui MT, Maleki Z, Ali SZ. Cytopathologic characteristics of epithelioid vascular malignancies. Acta Cytol. 2014;58:356–66.

    Article  PubMed  Google Scholar 

  31. Harman M, Nart D, Acar T, Elmas N. Primary mesenchymal liver tumors: radiological spectrum, differential diagnosis, and pathologic correlation. Abdom Imaging. 2015;40:1316–30.

    Article  PubMed  Google Scholar 

  32. Ahrens WA, Ridenour RV III, Caron BL, Miller DV, Folpe AL. GLUT-1 expression in mesenchymal tumors: an immunohistochemical study of 247 soft tissue and bone neoplasms. Hum Pathol. 2008;39:1519–26.

    Article  CAS  PubMed  Google Scholar 

  33. Das DK, Bhambhani S, Pant CS. Ultrasound guided fine-needle aspiration cytology: diagnosis of hydatid disease of the abdomen and thorax. Diagn Cytopathol. 1995;12:173–6.

    Article  CAS  PubMed  Google Scholar 

  34. Babu KS, Goel D, Prayaga A, Rao IS, Kumar A. Intraabdominal hydatid cyst: a case report. Acta Cytol. 2008;52:464–6.

    Article  PubMed  Google Scholar 

  35. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  Google Scholar 

  36. Islami F, Miller KD, Siegel RL, Fedewa SA, Ward EM, Jemal A. Disparities in liver cancer occurrence in the United States by race/ethnicity and state. CA Cancer J Clin. 2017;67:273–89.

    Article  PubMed  Google Scholar 

  37. Nault JC. Pathogenesis of hepatocellular carcinoma according to aetiology. Best Pract Res Clin Gastroenterol. 2014;28:937–47.

    Article  CAS  PubMed  Google Scholar 

  38. Charrez B, Qiao L, Hebbard L. Hepatocellular carcinoma and non-alcoholic steatohepatitis: the state of play. World J Gastroenterol. 2016;22:2494–502.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Nishida N, Kudo M. Clinical significance of epigenetic alterations in human hepatocellular carcinoma and its association with genetic mutations. Dig Dis. 2016;34:708–13.

    Article  PubMed  Google Scholar 

  40. Jain D. Tissue diagnosis of hepatocellular carcinoma. J Clin Exp Hepatol. 2014;4(Suppl 3):S67–73.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Soudah B, Schirakowski A, Gebel M, Potthoff A, Braubach P, Schlue J, et al. Overview and evaluation of the value of fine needle aspiration cytology in determining the histogenesis of liver nodules: 14 years of experience at Hannover Medical School. Oncol Rep. 2015;33:81–7.

    Article  CAS  PubMed  Google Scholar 

  42. Wee A. Fine-needle aspiration biopsy of hepatocellular carcinoma and related hepatocellular nodular lesions in cirrhosis: controversies, challenges, and expectations. Patholog Res Int. 2011;2011:587936.

    PubMed  PubMed Central  Google Scholar 

  43. Saleh HA, Aulicino M, Zaidi SY, Khan AZ, Masood S. Discriminating hepatocellular carcinoma from metastatic carcinoma on fine-needle aspiration biopsy of the liver: the utility of immunocytochemical panel. Diagn Cytopathol. 2009;37:184–90.

    Article  PubMed  Google Scholar 

  44. Khurana U, Handa U, Mohan H, Sachdev A. Evaluation of aspiration cytology of the liver space occupying lesions by simultaneous examination of smears and cell blocks. Diagn Cytopathol. 2009;37:557–63.

    Article  PubMed  Google Scholar 

  45. Yan BC, Gong C, Song J, Krausz T, Tretiakova M, Hyjek E, et al. Arginase-1: a new immunohistochemical marker of hepatocytes and hepatocellular neoplasms. Am J Surg Pathol. 2010;34:1147–54.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Lau SK, Prakash S, Geller SA, Alsabeh R. Comparative immunohistochemical profile of hepatocellular carcinoma, cholangiocarcinoma, and metastatic adenocarcinoma. Hum Pathol. 2002;33:1175–81.

    Article  PubMed  Google Scholar 

  47. Wang HL, Kim CJ, Koo J, Zhou W, Choi EK, Arcega R, et al. Practical immunohistochemistry in neoplastic pathology of the gastrointestinal tract, liver, biliary tract, and pancreas. Arch Pathol Lab Med. 2017;141:1155–80.

    Article  PubMed  Google Scholar 

  48. Wennerberg AE, Nalesnik MA, Coleman WB. Hepatocyte paraffin 1: a monoclonal antibody that reacts with hepatocytes and can be used for differential diagnosis of hepatic tumors. Am J Pathol. 1993;143:1050–4.

    PubMed  PubMed Central  CAS  Google Scholar 

  49. Nautsch F, Ludwig JM, Xing M, Johnson KM, Kim HS. Racial disparities and sociodemographic differences in incidence and survival among pediatric patients in the United States with primary liver cancer: a surveillance, epidemiology, and end results (SEER) population study. J Clin Gastroenterol. 2017;52(3):262–7. https://doi.org/10.1097/MCG.0000000000000833.

    Article  Google Scholar 

  50. Vlajnic T, Brisse HJ, Aerts I, Fréneaux P, Cellier C, Fabre M, Klijanienko J. Fine needle aspiration in the diagnosis and classification of hepatoblastoma: analysis of 21 new cases. Diagn Cytopathol. 2017;45:91–100.

    Article  PubMed  Google Scholar 

  51. Fiegel HC, Glüer S, Roth B, Rischewski J, von Schweinitz D, Ure B, et al. Stem-like cells in human hepatoblastoma. J Histochem Cytochem. 2004;52:1495–501.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Razumilava N, Gores GJ. Cholangiocarcinoma. Lancet. 2014;383:2168–79.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Nakanuma Y, Sato Y, Harada K, Sasaki M, Xu J, Ikeda H. Pathological classification of intrahepatic cholangiocarcinoma based on a new concept. World J Hepatol. 2010;2:419–27.

    Article  PubMed  PubMed Central  Google Scholar 

  54. El-Fattah MA. Non-Hodgkin lymphoma of the liver: a US population-based analysis. J Clin Transl Hepatol. 2017;5:83–91.

    PubMed  PubMed Central  Google Scholar 

  55. Padhan RK, Das P, Shalimar. Primary hepatic lymphoma. Trop Gastroenterol. 2015;36:14–20.

    Article  PubMed  Google Scholar 

  56. Moriarty AT, Banks ER, Bloch T. Cytologic criteria for subclassification of Hodgkin’s disease using fine-needle aspiration. Diagn Cytopathol. 1989;5:122–5.

    Article  CAS  PubMed  Google Scholar 

  57. Campione S, Cozzolino I, Mainenti P, D’Alessandro V, Vetrani A, D’Armiento M. Hepatic epithelioid hemangioendothelioma: Pitfalls in the diagnosis on fine needle cytology and “small biopsy” and review of the literature. Pathol Res Pract. 2015;211:702–5.

    Article  CAS  PubMed  Google Scholar 

  58. Mitra V, Nayar MK, Leeds JS, Wadehra V, Haugk B, Scott J, et al. Diagnostic performance of endoscopic ultrasound (EUS)/endoscopic ultrasound—fine needle aspiration (EUS-FNA) cytology in solid and cystic pancreatic neuroendocrine tumours. J Gastrointestin Liver Dis. 2015;24:69–75.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Derek B. Allison M.D. & David Borzik M.D.

  2. Department of Pathology and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Qing Kay Li M.D., Ph.D., F.C.A.P.

Authors
  1. Derek B. Allison M.D.
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  2. David Borzik M.D.
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  3. Qing Kay Li M.D., Ph.D., F.C.A.P.
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Corresponding author

Correspondence to Qing Kay Li M.D., Ph.D., F.C.A.P. .

Editor information

Editors and Affiliations

  1. The University of Michigan-Michigan Medicine, Ann Arbor, Michigan, USA

    Xin Jing

  2. Weill-Cornell Medicine, New York, New York, USA

    Momin T. Siddiqui

  3. The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

    Qing Kay Li

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Allison, D.B., Borzik, D., Li, Q.K. (2018). Liver Cytology. In: Jing, X., Siddiqui, M., Li, Q. (eds) Atlas of Non-Gynecologic Cytology . Atlas of Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-89674-8_7

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  • DOI: https://doi.org/10.1007/978-3-319-89674-8_7

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  • Online ISBN: 978-3-319-89674-8

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