DIFFERENTIAL DIAGNOSTIC DILEMMAS IN MALIGNANT FINE-NEEDLE ASPIRATES OF LIVER - A PRACTICAL APPROACH TO FINAL DIAGNOSIS

We retrospectively reviewed two hundred malignant fine-needle aspirate s of liver. Of these 49.5% were metastatic neoplasms, 32% were hepatoc ellular carcinomas, and 18.5% presented with diagnostic dilemmas. In l ess than half of these diagnostic challenges, differential diagnosis w as between hepatocellular carcinoma and metastatic adenocarcinoma. The remainder of cases involved a variety of metastatic neoplasms. Cytomo rphology in association with immunocytochemistry resolved the diagnost ic problems in about half of the problematic cases. Three cases were u ndifferentiated and remained unclassifiable. We conclude that approxim ately 80% of malignant lesions of liver can be correctly diagnosed by thorough cytomorphologic analysis and good clinical correlation, and 2 0% pose differential diagnostic dilemmas. (C) 1995 Wiley-Liss, Inc.