title: Fine needle aspiration biopsy of hepatocellular carcinoma. Value of immunocytochemical and ultrastructural studies.
abstract: Over three years, 365 fine needle aspiration biopsies (FNABs) of the liver were performed at Ottawa Civic Hospital. Fifty-nine percent of these aspirates were positive for malignancy. A diagnosis of hepatocellular carcinoma (HCC) was made in 20 liver aspirates. The initial light microscopic diagnoses of HCC were confirmed by immunocytochemical and/or electron microscopic (EM) studies in 16 aspirates. Canalicular pattern of staining with antibody to carcinoembryonic antigen (CEA), positive staining with anticytokeratin AE3 and negative staining with anticytokeratin AE1 supported the diagnosis of HCC. Although alpha-fetoprotein (AFP) expression is relatively specific for HCC, it was positive in only 44% of cases, and the staining was usually focal. EM study confirmed the diagnosis of HCC in seven cases. Based on our findings and published reports, we use a diagnostic panel of antibodies to CEA, AFP and anticytokeratins AE1 and AE3, and/or EM study when there is a suggestion of HCC cytologically or clinically.
authors.affiliation: Department of Laboratory Medicine, Ottawa Civic Hospital, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Guindi
authors.forename: H M
authors.initials: HM
authors.lastname: Yazdi
authors.forename: M A
authors.initials: MA
authors.lastname: Gilliatt
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle / Q000379:methods; D002272:Carcinoembryonic Antigen / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000648:ultrastructure; D002466:Cell Nucleolus / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D007633:Keratins / Q000032:analysis; D008113:Liver Neoplasms / Q000473:pathology* / Q000648:ultrastructure; D008297:Male; D008854:Microscopy, Electron; D012189:Retrospective Studies; D013194:Staining and Labeling; D014746:Vimentin / Q000032:analysis; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D006514:Hepatitis B Surface Antigens; D014746:Vimentin; D000509:alpha-Fetoproteins; D007633:Keratins