Fine-Needle Aspiration Biopsy of Hepatocellular Carcinoma and Related Hepatocellular Nodular Lesions in Cirrhosis: Controversies, Challenges, and Expectations
Figure 12
FNA of highly well-differentiated hepatocellular carcinoma from a “nodule-in-nodule” lesion. (a) Small and monotonous malignant hepatocytes exhibit decreased dense cytoplasm, central to slightly eccentric nuclei, increased nuclear-cytoplasmic ratio, and impression of nuclear crowding with closer inter-nuclear distances. Transgressing endothelium is present. Cytologic features are difficult to distinguish from those of a high-grade dysplastic nodule with small cell change. (Papanicolaou, ×200) (b) Two populations of dissociated hepatocytes are present. The malignant cells have dense eosinophilic cytoplasm with higher nuclear-cytoplasmic ratio. The nonneoplastic cells from the parent nodule have ample paler cytoplasm and normal nuclear-cytoplasmic ratio (Papanicolaou, ×200).
