Spleen metastasis from hepatocellular carcinoma: report of a case with diagnosis by fine needle aspiration cytology.
BACKGROUND
Metastasis of hepatocellular carcinoma (HCC) to various organs is frequently seen. The lungs, regional lymph nodes, kidney, bone marrow and adrenals are relatively common sites of metastasis. Spleen metastasis from HCC is unusual, and only a few cases have been retorted; none have been diagnosed by fine needle aspiration cytology (FNAC).


METHODS
A 54-year-old male visited our institute with chief complaints of abdominal pain and mild ascites. Multifocal HCC and an isolated splenic mass lesion were detected on abdominal ultrasound and computed tomography. FNAC was performed under ultrasound guidance from the liver and spleen mass lesions. Cytologic examination of the aspirates showed classical features of hepatocellular carcinoma and similar tumor cells with hepatocytic differentiation in the spleen. Immunocytochemistry for hepatocyte paraffin-1 confirmed the splenic metastasis of HCC.


CONCLUSIONS
Splenic metastasis from HCC diagnosed by FNAC is an exceptional situation; herein we confirm the rarity of this pathology and the efficacy of FNAC as a safe and valuable diagnostic tool for evaluating splenic lesions in oncologic patients.
Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Rajan
R
Duggal
Mandeep
M
Garg
Naveen
N
Kalra
Radhika
R
Srinivasan
Yogesh
Y
Chawla
D044963:Biopsy, Fine-Needle; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000473:pathology*; D013160:Splenic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed