Fine needle aspiration cytology of infantile haemangioendothelioma of the liver: a report of two cases

Abstract

E. Sigamani, V. K. Iyer and S. Agarwala Fine needle aspiration cytology of infantile haemangioendothelioma of the liver: a report of two cases Background: Fine needle aspiration cytology (FNAC) of infantile haemangioendothelioma of the liver (IHL) has not previously been described because routine use of FNAC is contraindicated due to the risk of bleeding. Methods and materials: Two patients presented with progressively increasing right upper quadrant abdominal mass. The index case was a girl aged two and a half years with a large single mass in the right lobe of the liver. The second was a 3‐month‐old girl in whom ultrasonography revealed multiple hypoechoic lesions in the liver. Ultrasound‐guided fine needle aspiration had been performed on both patients. May‐Grünwald‐Giemsa stained smears from these two patients were reviewed and correlated with histopathology. Results: Both aspirates showed predominantly normal hepatocytes and bile ductules amongst which tumour cells were admixed. The latter were oval to spindle‐shaped with scant cytoplasm and wavy, kinked and indented nuclear outlines. The non‐epithelial character of the tumour cells was apparent and helped to rule out hepatoblastoma. One case showed extramedullary haemopoiesis. The diagnosis of IHL was established on subsequent excision in the first case and a wedge biopsy in the second case. CD34 and factor VIII R antigen were positive in the tumour cells. Conclusion: Radiological diagnosis of IHL is possible in a majority of cases, but sometimes features may overlap with hepatoblastoma and fine needle aspiration may be performed inadvertently. Characteristic kinked nuclei and intermixed normal liver tissue might suggest IHL in the differential diagnosis of a spindle cell vasoformative tumour.

Cytomorphology of hepatoblastoma with histological correlation and role of SALL4 immunocytochemistry in its diagnosis, subtyping, and prognostication

“…HB is the most common primary hepatic tumor of childhood but needs to be distinguished from other rarer pediatric liver tumors . The diagnosis of HB can be suspected on the basis of clinical presentation, radiological features, and raised serum AFP levels.…”

“…HB is the most common primary hepatic tumor of childhood but needs to be distinguished from other rarer pediatric liver tumors. 3,11,[15][16][17] The diagnosis of HB can be suspected on the basis of clinical presentation, radiological features, and raised serum AFP levels. However, a precise pathological diagnosis, including tumor subtyping and prognostic morphological features, is essential for therapeutic purposes.…”

Cytomorphological Features of Epithelioid Hemangioendothelioma in Ascitic Fluid with Radiological, Clinical and Histopathological Correlations

“…Due to its epithelioid morphology and ‘signet ring' cell configuration, EHE may mimic various pathological entities such as mesothelioma, adenocarcinoma, melanoma, and fibrous histiocytoma [2,3,4]. The cytomorphology of EHE specimens from fine-needle aspirates of solid tumors has been well described [4,5,6,7,8,9], but the cytological features of these tumors in effusions are limited to descriptions of only 5 cases, all of which are pleural fluids. Clinically aggressive types of EHE tend to involve the pleura and peritoneum [10], and the exfoliated tumor cells account for those found in effusions.…”

Fine‐needle aspiration for proteomic study of tumour tissues

“…FNA has been demonstrated to be an accurate, rapid, minimally invasive and cost‐effective technique for the cytological diagnosis of mass lesions in various organs and tissues. Many reviews on this topic are present in the literature, and in Table 1 we have summarized the most recent and significant ones 3–43.…”