title: Primary and secondary hepatic lymphomas diagnosed by image-guided fine-needle aspiration: a retrospective study of clinical and cytomorphologic findings.
abstract: OBJECTIVE
  To explore the diagnosis of hematolymphoid malignancies of the liver (hepatic lymphoma [HeL]) by image-guided fine-needle aspiration (FNA), which can often be difficult due to a low index of suspicion and nonspecific patient presentations, especially in the rare cases where the liver is the only site of disease (primary HeL [PHeL]). Understanding the clinical setting in which such lesions arise, as well as the cytomorphologic findings, may assist cytopathologists in making an accurate diagnosis and triaging samples for ancillary studies.
  
  
  METHODS
  In this retrospective study of 32 patients with HeL, the largest such study to our knowledge, we review the clinical and diagnostic features of HeL.
  
  
  RESULTS
  HeL and especially PHeL most commonly show a diffuse large B-cell lymphoma phenotype and have a poor prognosis (median survival of seven months). PHeL is strongly associated with human immunodeficiency virus infection (12/16 patients).
  
  
  CONCLUSIONS
  Image-guided FNA with immediate evaluation is a reliable means to obtain diagnostic material and triage for ancillary tests.
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Room H185C, Atlanta, GA 30322; mjswadley@emory.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Swadley
authors.forename: Matea
authors.initials: M
authors.lastname: Deliu
authors.forename: Marina B
authors.initials: MB
authors.lastname: Mosunjac
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Gunthel
authors.forename: Minh Ly T
authors.initials: ML
authors.lastname: Nguyen
authors.forename: Krisztina Z
authors.initials: KZ
authors.lastname: Hanley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications; D006801:Humans; D061705:Image-Guided Biopsy; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Fine-needle aspiration; HIV; Hematolymphoid; Hepatic; Liver; Lymphoma; Primary cytology