title: Hepatoblastoma. Report of a case with cytologic, histologic and ultrastructural findings.
abstract: Hepatoblastoma, although rare, is the most common primary malignant neoplasm of the liver in children. In this paper we describe a case of hepatoblastoma with unusual cytologic features and present the histologic, immunocytochemical and ultrastructural features of this neoplasm. A 7-month-old girl presented with a large hepatic mass and metastatic nodules in both lungs. Intraoperative biopsy revealed a hepatoblastoma. Aspiration biopsy yielded a highly cellular aspirate with cords of pleomorphic cells embedded in a mucoid matrix. Histologic sections showed a diffusely infiltrative neoplasm composed of sheets and cords of highly pleomorphic cells. The neoplastic cells stained strongly positive for cytokeratin CAM 5.2 and AE1 and focally positive for alpha-fetoprotein, ferritin, carcinoembryonic antigen and vimentin. Ultrastructurally, the neoplastic cells had abundant intercellular junctions and intracytoplasmic aggregates of intermediate filaments. A mucoid matrix, to our knowledge, has not been reported as a finding on aspiration biopsy. This patient presented with pulmonary metastases, and thus we think the mucoid matrix may be a marker of a more aggressive variant of hepatoblastoma. This case illustrates additional cytologic features of hepatoblastoma and the usefulness of aspiration biopsy in the rapid diagnosis of this rare tumor.
authors.affiliation: Department of Pathology, New York University, New York.
authors.forename: J
authors.initials: J
authors.lastname: Cangiarella
authors.forename: M A
authors.initials: MA
authors.lastname: Greco
authors.forename: J
authors.initials: J
authors.lastname: Waisman
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D018197:Hepatoblastoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000648:ultrastructure; D006801:Humans; D007223:Infant; D007633:Keratins / Q000032:analysis; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000648:ultrastructure; D008175:Lung Neoplasms / Q000556:secondary; D008854:Microscopy, Electron; D014750:Vincristine / Q000008:administration & dosage; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins; D014750:Vincristine; D007633:Keratins; D002945:Cisplatin; D005472:Fluorouracil