Cytologic findings of metastatic hepatocellular carcinoma of the nasal cavity: a report of 2 cases.
BACKGROUND
Hepatocellular carcinoma metastasizing to the nasal cavity is rare, but nasal bleeding caused by it is difficult to treat. The reason is that a large majority of patients have a bleeding tendency due to liver cirrhosis. Accordingly, early and correct diagnosis is essential.


METHODS
Case 1, a Japanese man in therapy for C type liver cirrhosis and hepatocellular carcinoma, was diagnosed as metastasis to the bones, and then he was admitted. After hospitalization, he complained of nasal obstruction. Fine needle aspiration biopsy from a tumor occupying nasal and maxillary cavities showed overlapped cells and scattered cells having a round to oval nucleus containing one or a few large nucleoli. The characteristics of cells indicated metastasis of hepatocellular carcinoma. In case 2, a Japanese man under treatment for liver cancer visited our hospital with a complaint of nasal obstruction. In fine needle aspiration biopsy from a mass in the right nasal cavity, cohesive clusters and sparse neoplastic cells similar to those observed in the first case were found.


CONCLUSIONS
Aspiration cytology is useful in the diagnosis and treatment of hepatocellular carcinoma metastatic to the nasal cavity. Finding characteristic cells is important in the diagnosis. Clinical information is sure to be a convincing clue.
Department of Pathology, Osaka Medical College, Daigaku-Machi 2-7, Osaka 569-8686, Japan. pa1021@art.osaka-med.ac.jp
Yoshitaka
Y
Kurisu
Motomu
M
Tsuji
Atsushi
A
Takeshita
Kouichi
K
Hirata
Yuro
Y
Shibayama
D000368:Aged; D044963:Biopsy, Fine-Needle; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D009296:Nasal Cavity / Q000473:pathology*; D009669:Nose Neoplasms / Q000473:pathology / Q000556:secondary*