Release Date: Apr 2017
CC: PC, MK, PBL, ICS, SBP
Aileen Wee, MBBS, FRCPA, FRCPath
Senior Consultant Pathologist, National University Hospital, Singapore; Professor of Pathology, Yong Loo Lin School Of Medicine-National University of Singapore
The cytologic and histologic diagnosis of tumors and tumor-like lesions in the liver can prove challenging on small tissue samples (fine needle aspiration biopsies, cell blocks and core biopsies). The liver often undergoes cirrhosis with development of a spectrum of hepatocellular nodular lesions of variable biologic status, all of which have to be distinguished from hepatocellular carcinoma (HCC). The organ is a common depository for secondaries from all parts of the body and these can mimic HCC and cholangiocarcinoma, with their variations and variants, and vice versa. This session provides a pragmatic algorithmic approach to cytohistologic diagnosis of small tissue samples based on pattern recognition and cell profiling emphasizing clinico-radiologic-pathologic correlation. The morphologic roadmaps comprise hepatocellular/epithelioid, glandular/biliary/papillary, mixed epithelioid-glandular (hepatobiliary), and cystic patterns. The predominant cell profiles include squamous, small/intermediate, large, polygonal, clear, oncocytic, transitional, fat-containing, pleomorphic, spindle, giant and hematopoietic/inflammatory cell types, and others. Key cytologic and histologic features, practical points and pitfalls, and role of immunohistochemistry are discussed. This session hopes to strengthen the bridge between surgical pathology and cytopathology, providing pathologists with the confidence to diagnose small liver samples. Knowledge of the basic fundamentals of liver histology and cytology is assumed.
After attending this session, participants will be able to:
- Approach the cytologic and histologic diagnosis of focal liver lesions along a structured algorithm based on pattern recognition and cell profiling.
- Distinguish the various differential diagnoses for common problematic patterns and cell types.
- Utilize ancillary tests such as immunohistochemistry in an appropriate and expedient manner.
- Appreciate the importance of clinic-radiologic-pathologic correlation before rendering a definitive diagnosis
Who should attend? Practicing Pathologists, Residents, Pathologists' Assistants, Cytotechnologist