FINE-NEEDLE ASPIRATION BIOPSY OF SMALL INTERMEDIATE CELL TUMORS IN THE LIVER - CONSIDERATIONS IN A SOUTHEAST-ASIAN POPULATION

OBJECTIVE: To assess the diagnostic problems and accuracy involved in rendering an exact cytologic diagnosis, including reference to a prima ry site of origin, on fine needle aspiration biopsies (FNABs) of small /intermediate cell tumors of the liver. STUDY DESIGN: Thirty-live hepa tic FNABs of small/intermediate tumors, neuroendocrine tumors (NETs) a nd poorly differentiated or undifferentiated cancers occurring in adul ts were analyzed. Ancillary studies, including immunohistochemistry, w ere performed whenever necessary. All other relevant histopathologic s ections and medical records were reviewed. RESULTS: There were 26 meta stases, while 9 were considered primary lesions. The aspirates were ca tegorized into 11 NETs (pancreas 5, lung 1, liver 2, unknown primary 3 ); 9 undifferentiated nasopharyngeal carcinomas; 2 small cell undiffer entiated carcinomas (lung 2); 4 undifferentiated carcinomas, not other wise specified (lung 1, pancreas 1, liver 1, unknown 1); 1 lobular-duc tal carcinoma (breast); 1 glioblastoma multiforme (brain); 1 ovarian c arcinoma; 1 non-Hodgkin's lymphoma (liver); and 5 primary hepatocellul ar carcinomas. CONCLUSION: There was histologic and/or immunohistochem ical confirmation in 25 cases (72 %). Some of the limitations in categ orization of such tumors obtained by FNAB can be overcome by immunohis tochemistry. Information gleaned from a precise cytologic diagnosis ca n sometimes only favor a particular primary site.