DNA ploidy was evaluated by image cytometry in a series of 84 hepatocellular carcinomas diagnosed by fine‐needle aspiration biopsy. In the series were included eight cases originally diagnosed as suspect and reclassified as well‐differentiated hepatocarcinoma. The study was retrospectively performed on Papanicolaou‐destained, Feulgen‐restained smears. The 5c exceeding rate and the visual interpretation of the corresponding histograms were evaluated and compared with size of the tumors, serum α‐fetoprotein values, hepatic functional staging, and patient survival. Sixty‐eight cases were aneuploid and 16 euploid (9 diploid and 7 polyploid). Four of the eight cytologically suspect cases were aneuploid. Statistical analysis showed an association between size and cytologic grading, 5c exceeding rate and cytologic grading, and between aneuploidy and multiple tumors; in a Cox multivariate DNA content analysis, aneuploidy and multiple tumors were the two prognostically significant variables. DNA ploidy evaluation by static cytometry of hepatic tumors may be useful in the diagnosis on cytologic samples and could represent an independent prognostic parameter in predicting the survival outcome of patients with hepatocellular carcinoma. Diagn. Cytopathol. 1998;19:323–329. © 1998 Wiley‐Liss, Inc.

Papillary carcinoma (PC) is a histological variant of breast carcinoma that is more frequently observed in males than in females, showing the same cytological features in both sexes. PC is characterized by a low grade of malignancy and a generally favorable course. We describe a case of male breast PC (MPC) diagnosed by fine-needle cytology (FNC) in which some aggressive morphologically detectable features were associated with bland cytologic features of the tumor. FNC was performed on a 3 cm palpable mass of the left breast of a 55-yr-old male. FNC yielded abundant bloody material. Two smears were Diff-Quik and Papanicolaou stained, others were used for immunocytochemical assessment of estrogen, progesterone, c-erbB-2, and Ki-67; another was Feulgen stained for DNA ploidy. Smears were highly cellular, showing isolated cells and papillary structures. Cells showed tall and well-defined cytoplasm with a columnar aspect, light anisonucleosis, coarse chromatin, and small nucleoli. Immunoperoxidase staining demonstrated positivity for estrogen (50%), negativity for progesterone, intense positivity for c-erbB-2, with specific membrane staining and positivity for Ki-67 in more than 20% of the cells. DNA-ploidy showed an aneuploid histogram with 5c exceeding rate (5cER) of 59% and 2c deviation index (2cDI) of 29%. Subsequent surgical pathology examination confirmed the cytological diagnosis of papillary carcinoma; moreover, it revealed neoplastic endolymphatic thrombi and infiltrative border of the tumor that reached the thoracic wall. Cytological features can suggest diagnosis of MPC on FNC samples. Immunocytochemical evaluation of c-erbB-2 and Ki-67 and DNA ploidy evaluation on cytological smears might reveal a biological aggressiveness of PC despite the bland microscopic features of the tumor and this should influence the therapeutic procedure.