This is a two year study of 530 liver aspirates that included 40 benign and292malignanttumours. Smears from hepatocellular carcinomas were cellular and showed a complex ramifying Staghorn pattern. Nodular aggregates covered by endothelium and projecting within sinusoids were characteristic. Smears of cirrhosis showed smaller fragments with loosely arranged hepatocytes. Cytological variation within single cell clusters was seen in contrast to uniform atypia within a single cell cluster in hepatocellular carcinoma. Metastatic tumours showed interspersed clusters of normal hepatocytes and cytological features specific to the primary tumour. The commonest metastatic tumour was gastrointestinal adenocarcinoma. In 16cases, it was impossible to differentiate the primary or the metastatic nature of the tumour. In 16 cases, it was difficult to pinpoint the source of the metastasis. The general diagnostic yield of FNAC was 62.6% whereas that of guided FNAC was 53.8%. We attribute the latter to small sample size and the fact that guided FNAC was reserved for inaccessible, deep seated lesions and sometimes doubtful lesions.
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