Cytologic changes in hepatocellular carcinoma after percutaneous acetic acid injection - Correlation with helical computed tomography findings

OBJECTIVE: To illustrate the cytologic features of hepatocellular carcinoma (HCC) after percutaneous acetic acid injection (PAI) and to correlate the cytologic findings with helical computed tomography (CT)findings. STUDY DES IGN: The study included 30 patients with 37 HCC who had undergone PAI. Base line cytomorphology of HCC was evaluated by needle aspiration in all cases. PAI tinder ultrasound guidance was done every three to seven days. Upon co mpletion of PAI, fine needle aspiration cytology was performed and followed by helical CT within two weeks. The degeneration of HCC after PAI was clas sified into two grades. Grade 1 showed incomplete degeneration (99% of nucl ear area); grade 2 showed complete degeneration or severe degeneration with cell debris or amorphous material only. The specimens were stained with Ri u's method (Romanowsky system). RESULTS: The cytologic changes after PAI included decreased cell number, re duced cellular aggregation, degeneration of cytoplasm and nucleus, and eosi nophilic or basophilic background in all tumors. In all the 37 tumors witho ut enhancement on helical CT, grade 2 degeneration was detected. CONCLUSION: Our results reveal that grade 2 degeneration alone, demonstrate d cytologically, could indicate almost complete necrosis of HCC after PAI, probably implying no need for booster PAI.