Cytological Differential Diagnosis Criteria of Liver Masses

Abstract

Introduction: The objective of the study was to determine the critical diagnostic cytological features of the liver masses. Methods: This retrospective study was conducted with 137 fine needle aspiration biopsies diagnosed in a 5-year period in Haydarpaşa Numune Hospital. All the glass slides of the cases were re-evaluated and 11 cytomorphologic features were investigated in each case. The results were evaluated by Stepwise Logistic Regression Analysis method. Results: Monotonous atypia, atypical hepatocytic naked nuclei, increased nucleus/cytoplasm (N/C) ratio, and hepatocytic morphology were critical for differential diagnosis of hepatocellular carcinoma (HCC) and metastasis. Increase N/C ratio and the absence of bile duct epithelial cells were critically important for differential diagnosis of HCC from benign liver mass. Discussion and Conclusion: Cytological diagnosis of liver mass is not difficult in cases where cytomorphological features are sufficient. The efficacy of cytology in the differentiation of benign liver masses from HCC is limited. This can be achieved by performing immunohistochemistry to the cell block. Cytopathologic diagnosis should be confirmed with radiological and biochemical results.