Role of FNA and Core Biopsy of Primary and Metastatic Liver Disease
Figure 2
. History: 61 year-old-male with AFP of 149 with alcoholic cirrhosis and HCC after transplant. (a) Arterial phase MRI, postgadolinium LAVA sequence showing arterial enhancing lesion (arrow). (b) Post gadolinium MRI during the portal venous phase showed central washout with well defined capsule (arrow). (c) Fine needle aspiration and core were obtained. Fine needle aspiration was suspicious for well differentiated HCC but could not exclude adenoma. Deeper sections of the cell block material revealed acinar-like and branched trabecular patterns of hepatocytes as well as an altered reticulin pattern (not shown). Based on the deeper sections and the positive IHC stain results for glypican-3 (shown here) and Hep Par 1 (not shown), the biopsy is consistent with hepatocellular carcinoma, well-differentiated. Patient had RFA and then liver transplant which revealed HCC.
