CYTOMORPHOLOGIC AND DNA CYTOMETRIC FEATURES OF HEPATOCELLULAR-CARCINOMA IN FINE-NEEDLE ASPIRATES

OBJECTIVE: To classify hepatocellular carcinoma according to DNA ploid y patterns and to evaluate distinct cytomorphologic features of hepato cellular carcinoma that correlate with DNA ploidy patterns. STUDY DESI GN: Fine needle aspiration smears of 36 histologically proven hepatoce llular carcinomas were performed for DNA measurement by image analysis after Feulgen restaining of the specimens. Nuclear features-prominent nucleoli, nuclear cleavage, nuclear area and nuclear/cytoplasmic rati o-were correlated with the DNA ploidy patterns. RESULTS: Of the 36 cas es, 24 were either diploid (n = 7) or polyploid (n = 7); 19 tumors had a single aneuploid stemline, 2 cases had multiple stemlines, and 2 ca se had no discernible stemline. A preponderance of prominent nucleoli was seen in 7/7 diploid tumors (2c), 6/7 polyploid tumors (4c, 8c) and 6/8 aneuploid tumors (>4c). Conspicuous nuclear cleavage in a high nu mber of tumor cells was present substantially in tumors with large nuc lear areas (4c, > 4c). CONCLUSION Most hepatocellular carcinoma studie d had a distinct stemline so that the tumors could be designated DNA d iploid, polyploid or aneuploid. The prevalence of prominent nucleoli a nd nuclear cleavage was a distinguishing cytologic feature that could predict DNA ploidy patterns. No special association of the nuclear/cyt oplasmic ratio with any of the ploidy groups was noted.