• Yener S. Erozan
  • Armanda Tatsas
Part of the Essentials in Cytopathology book series (EICP, volume 18)


Key diagnostic features of normal and abnormal liver fine needle aspirates are discussed. Neoplastic lesions, including primary benign and malignant tumors, as well as metastatic lesions are presented in detail.


Neuroendocrine Tumor Needle Core Biopsy Cirrhotic Liver Focal Nodular Hyperplasia Intranuclear Inclusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading


  1. Assy N, Nasser G, Djibre A, et al. Characteristics of common solid liver lesions and recommendations for diagnostic workup. World J Gastroenterol. 2009a;15:3217–27.PubMedCentralPubMedCrossRefGoogle Scholar
  2. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med. 2001;344:495–500.PubMedCrossRefGoogle Scholar
  3. Franca AV, Valerio HM, Trevisan M, et al. Fine needle aspiration biopsy for improving the diagnostic accuracy of cut needle biopsy of focal liver lesions. Acta Cytol. 2003;47:332–6.PubMedCrossRefGoogle Scholar
  4. Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice. British Society of Gastroenterology. Gut. 1999;45 Suppl 4:IV1–11.PubMedCentralPubMedGoogle Scholar
  5. Karhunen PJ. Benign hepatic tumours and tumour like conditions in men. J Clin Pathol. 1986;39:183–8.PubMedCentralPubMedCrossRefGoogle Scholar
  6. McGill DB, Rakela J, Zinsmeister AR, et al. A 21-year experience with major hemorrhage after percutaneous liver biopsy. Gastroenterology. 1990;99:1396–400.PubMedGoogle Scholar
  7. Schwartz LH, Gandras EJ, Colangelo SM, et al. Prevalence and importance of small hepatic lesions found at CT in patients with cancer. Radiology. 1999;210:71–4.PubMedCrossRefGoogle Scholar
  8. Stewart CJ, Coldewey J, Stewart IS. Comparison of fine needle aspiration cytology and needle core biopsy in the diagnosis of radiologically detected abdominal lesions. J Clin Pathol. 2002;55:93–7.PubMedCentralPubMedCrossRefGoogle Scholar
  9. Winter TC, Lee Jr FT, Hinshaw JL. Ultrasound-guided biopsies in the abdomen and pelvis. Ultrasound Q. 2008;24:45–68.PubMedCrossRefGoogle Scholar


  1. Guy CD, Ballo MS. Fine needle aspiration biopsy of the liver. Adv Anat Pathol. 1999;6:303–16.PubMedCrossRefGoogle Scholar

Hepatobiliary Cystadenoma

  1. Ahmad I, Iyer A, Marginean CE, et al. Diagnostic use of cytokeratins, CD34, and neuronal cell adhesion molecule staining in focal nodular hyperplasia and hepatic adenoma. Hum Pathol. 2009;40:726–34.PubMedCrossRefGoogle Scholar
  2. Cohen MB, Haber MM, Holly EA, et al. Cytologic criteria to distinguish hepatocellular carcinoma from nonneoplastic liver. Am J Clin Pathol. 1991;95:125–30.PubMedGoogle Scholar
  3. Hussain SM, Terkivatan T, Zondervan PE, et al. Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis. Radiographics. 2004;24:3–19.PubMedCrossRefGoogle Scholar
  4. Parwani AV, Burroughs FH, Ali SZ. Echinococcal cyst of the liver. Diagn Cytopathol. 2004;31:111–2.PubMedCrossRefGoogle Scholar
  5. Ruschenburg I, Droese M. Fine needle aspiration cytology of focal nodular hyperplasia of the liver. Acta Cytol. 1989;33:857–60.PubMedGoogle Scholar
  6. Yang GC, Yang GY, Tao LC. Distinguishing well-differentiated hepatocellular carcinoma from benign liver by the physical features of fine-needle aspirates. Mod Pathol. 2004;17:798–802.PubMedCrossRefGoogle Scholar

Rare Primary Malignant Neoplasms

  1. Assy N, Nasser G, Djibre A, et al. Characteristics of common solid liver lesions and recommendations for diagnostic workup. World J Gastroenterol. 2009b;15:3217–27.PubMedCentralPubMedCrossRefGoogle Scholar
  2. Barwad A, Gupta N, Gupta K, et al. Hepatoblastoma—an attempt of histological subtyping on fine-needle aspiration material. Diagn Cytopathol. 2013;41:95–101.PubMedCrossRefGoogle Scholar
  3. Das DK. Cytodiagnosis of hepatocellular carcinoma in fine-needle aspirates of the liver: its differentiation from reactive hepatocytes and metastatic adenocarcinoma. Diagn Cytopathol. 1999;21:370–7.PubMedCrossRefGoogle Scholar
  4. Kakar S, Gown AM, Goodman ZD, et al. Best practices in diagnostic immuno-histochemistry: hepatocellular carcinoma versus metastatic neoplasms. Arch Pathol Lab Med. 2007a;131:1648–54.PubMedGoogle Scholar
  5. Kulesza P, Torbenson M, Sheth S, et al. Cytopathologic grading of hepatocellular carcinoma on fine-needle aspiration. Cancer. 2004;102:247–58.PubMedCrossRefGoogle Scholar
  6. Wakely Jr PE, Silverman JF, Geisinger KR, et al. Fine needle aspiration biopsy cytology of hepatoblastoma. Mod Pathol. 1990;3:688–93.PubMedGoogle Scholar
  7. Wee A. Fine needle aspiration biopsy of hepatocellular carcinoma and hepatocellular nodular lesions: role, controversies and approach to diagnosis. Cytopathology. 2001;220:287–305.Google Scholar

Metastatic Neoplasms to Liver

  1. Centeno BA. Pathology of liver metastases. Cancer Control. 2006;13:13–26.PubMedGoogle Scholar
  2. Kakar S, Gown AM, Goodman ZD, et al. Best practices in diagnostic immunohistochemistry: hepatocellular carcinoma versus metastatic neoplasms. Arch Pathol Lab Med. 2007b;131:1648–54.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Yener S. Erozan
    • 1
  • Armanda Tatsas
    • 2
  1. 1.Department of PathologyThe Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Pathology Group of LouisianaBaton RougeUSA

Personalised recommendations