Abstract
Hepatocellular carcinoma (HCC) is gaining clinical importance because of its increasing worldwide incidence. It is the fifth most common cancer in the world with more than 1 million deaths annually. It is no longer a disease of developing countries associated with hepatitis B virus (HBV) infection or aflatoxin exposure. Percutaneous radiologically guided hepatic fine-needle aspiration biopsy (FNAB) is widely performed for HCC. The diagnosis of HCC is not difficult with optimal specimen procurement and processing, combined cytohistologic approach, judicious use of ancillary techniques, close clinicopathologic correlation, and trained expertise. The sensitivity of hepatic FNAB diagnosis of malignancy is about 85%, whereas the specificity approaches 100%. However, distinguishing a highly well differentiated HCC (WDHCC) from benign hepatocellular nodular lesions can be extremely challenging. Immunohistochemistry (IHC) has an adjunctive role in enhancing the yield and precision of cytodiagnosis of such lesions. The FNAB material is routinely made into smears that are air-dried and stained with Diff-Quik or May–Grunwald–Giemsa (MGG) or fixed immediately in 95% ethanol and stained by the Papanicolaou method. Any particulate fragments/microbiopsy cores should be retrieved, fixed in 10% buffered formalin, and processed into cellblocks for histologic sections.
Published Version
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