Karim Rooshdiya Z, Greenberg Merle L
Department of Anatomical Pathology, Royal Prince Alfred Hospital, Central Sydney Area Health Service, Camperdown NSW 2050, Australia.
Diagn Cytopathol. 2006 Jun;34(6):430-3. doi: 10.1002/dc.20471.
Although hepatocellular carcinoma (HCC) is relatively rare in Western countries, it is one of the most prevalent cancers worldwide. Metastatic spread outside the liver is common and typically occurs in the setting of advanced disease. Metastatic disease is the initial presentation of HCC in less than 5% of cases and even fewer are diagnosed by cytology. We present the cytological findings in an 85-yr-old man of a soft tissue mass in the left temple, which suggested the diagnosis of an occult HCC. Fine-needle aspiration biopsy showed moderately cellular smears with large malignant epithelial cells present in fragments, with apposition of endothelial cells to the tumour cells. Deposits of non-refractile green pigment consistent with bile were present. Investigations revealed abnormal liver function tests, and a large mass replacing much of the liver. In view of the cytology and clinico-radiological correlation, a diagnosis of metastatic HCC was made.
虽然肝细胞癌（HCC）在西方国家相对少见，但它是全球最常见的癌症之一。肝外转移很常见，通常发生在疾病晚期。转移性疾病在不到5%的病例中是HCC的初始表现，通过细胞学诊断的更少。我们报告了一名85岁男性左颞部软组织肿块的细胞学检查结果，提示隐匿性HCC的诊断。细针穿刺活检显示涂片细胞中等丰富，有大片恶性上皮细胞碎片，内皮细胞与肿瘤细胞贴附。可见与胆汁一致的非折光性绿色色素沉着。检查发现肝功能试验异常，肝脏有一大块肿物，占据了肝脏的大部分。鉴于细胞学检查结果以及临床与影像学的相关性，诊断为转移性HCC。
