title: Hepatocellular carcinoma-fibrolamellar variant: cytopathology of an unusual case.
abstract: The fibrolamellar variant of hepatocellular carcinoma (FL-HCC) is an uncommon visceral malignancy with a distinctly better prognosis. An accurate initial diagnosis, therefore, is essential for prognostic and therapeutic reasons. This case report describes the cytomorphology of an unusual case of FL-HCC in a 13-yr-old boy who was found to have a hepatic mass with prominent intraluminal growth pattern seen predominantly in the right hepatic duct. A diagnosis of FL-HCC was originally suspected on bile duct brushings obtained during endoscopic retrograde choleangiopancreaticogram (ERCP) and subsequently confirmed on fine-needle aspiration (FNA) and surgical resection of the hepatic tumor. The cytomorphologic profile of FL-HCC is distinctive in the right clinical setting, allowing an accurate preoperative identification of this malignancy on biliary brushing or FNA.
authors.affiliation: Department of Pathology, The John K. Frost Cytopathology Laboratory, The Johns Hopkins Hospital, Baltimore, Maryland 21287-6417, USA.
authors.forename: George
authors.initials: G
authors.lastname: Kunz
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Chung
authors.forename: Syed Z
authors.initials: SZ
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D001652:Bile Ducts / Q000473:pathology; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome