Fine-Needle Aspiration Biopsy of Hepatocellular Carcinoma and Related Hepatocellular Nodular Lesions in Cirrhosis: Controversies, Challenges, and ExpectationsReport as inadecuate




Fine-Needle Aspiration Biopsy of Hepatocellular Carcinoma and Related Hepatocellular Nodular Lesions in Cirrhosis: Controversies, Challenges, and Expectations - Download this document for free, or read online. Document in PDF available to download.

Pathology Research InternationalVolume 2011 2011, Article ID 587936, 17 pages

Review ArticleDepartment of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074

Received 25 December 2010; Accepted 3 May 2011

Academic Editor: Darshana Jhala

Copyright © 2011 Aileen Wee. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The role of hepatic fine-needle aspiration FNA biopsy has evolved. Advances in imaging modalities have obviated the need for tissue confirmation in most hepatocellular carcinomas HCCs. There is risk of needle-tract seeding. Increasingly, small nodules are being detected on ultrasound surveillance of high-risk patients. Diagnostic challenges associated with cirrhosis include distinction of benign hepatocellular nodules, namely, large regenerative nodules and dysplastic nodules, from reactive hepatocytes; and distinction of well-differentiated HCCs from benign hepatocellular nodules. This paper will discuss i controversies regarding preoperative-pretransplantation FNA diagnosis of HCC, ii update of biological evolution, nomenclature, and histopathologic criteria for diagnosis of precancerous nodules and small HCCs, and iii algorithmic approach to FNA diagnosis of hepatocellular nodules. Optimal results depend on dedicated radiologist-cytopathologist team, on-site cytology service; combined cytohistologic approach, immunohistochemistry, and clinicopathologic correlation. Hepatic FNA is likely to be incorporated as a point of care as we move towards personalized medicine.





Author: Aileen Wee

Source: https://www.hindawi.com/



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