USE OF CD34 AND FACTOR-VIII TO DIAGNOSE HEPATOCELLULAR-CARCINOMA ON FINE-NEEDLE ASPIRATES

OBJECTIVE: The immunohistochemical staining patterns characteristic of hepatocellular carcinoma (HCC) using CD34 and factor VIII antibodies were compared with those of other hepatic lesions to determine if thes e stainings can be used as a diagnostic criterion. STUDY DESIGN: We re viewed 44 fine needle aspirates from the liver to evaluate the immunop eroxidase staining patterns on cell block preparations using CD34 and factor VIII and to determine whether this could distinguish HCC from t he other lesions. These included HCC (14 cases), metastatic tumor (14 cases) and nonneoplastic liver lesions (16 cases). RESULTS: This retro spective study showed that in the nine documented cases of HCC, staini ng for CD34 and/or factor VIII was positive. The pattern of staining w as either peripheral, around small clusters of tumor cells, or linear, diffuse and sinusoidal. In all the documented cases (27) of metastati c carcinoma and nonneoplastic lesions staining for CD34 and factor VII I was negative. In addition, there were eight problematic cases. In 7 cases the cytologic diagnosis on Papanicolaoustained smears was inconc lusive about HCC or metastatic carcinoma. CD34 and factor VIII confirm ed the final diagnosis on the cell blocks. Based on this staining, 4 w ere HCC, 2 were metastatic carcinoma and 1 was equivocal, most probabl y HCC. In one case the differential diagnosis between well-differentia ted HCC and a nonneoplastic liver lesion could not be made on cytologi c smears, and here, also, CD34 and factor VIII aided in the correct di agnosis of a nonneoplastic liver lesion. CONCLUSION: We suggest immuno peroxidase staining with CD34 and factor VIII be performed on the cell block sections from FNAs in any problematic hepatic case.