Parikh Biren, Jojo Annie, Shah Birwa, Bansal Rimpi, Trivedi Priti, Shah M J
Department of Pathology, The Gujarat Cancer & Research Institute, Civil campus, Asarwa, Ahmedabad.
Indian J Pathol Microbiol. 2005 Jul;48(3):331-6.
Hepatoblastoma (HBL) is the most common primary malignant hepatic tumor in children. The aim of the present study is to describe cytological findings of HBL, to subclassify it, and to discuss differential diagnoses. Twenty cases were taken from records of Cytopathology department, Gujarat Cancer and Research Institute, Ahmedabad. The aspiration smears were stained with Papanicolaou stain andlor Giemsa stain. Cytological and architectural criteria were applied to aspiration smears. Fifteen cases (75%) of HBL were diagnosed in the patients below the age of two years. The commonest presentation was found to be lump in abdomen. On the basis of cytoarchitectural features, HBL was classified in two groups undifferentiated and differentiated. Morphologically, the tumor cells were commonly arranged in acinar pattern, papillary pattern, or in sheets. FNA cytology alone had some limitations in the diagnosis of HBL. Hence, cytoarchitecture in combination with clinicalfeatures, imaging techniques and serum a-fetoprotein levels were helpful for specific diagnosis of HBL and to rule out various others differential diagnosis of small round cell tumor. The cytological differential diagnosis between differentiated HBL and Hepatocellular carcinoma (HCC) was found to be very difficult.
肝母细胞瘤（HBL）是儿童最常见的原发性肝脏恶性肿瘤。本研究的目的是描述HBL的细胞学表现，对其进行亚分类，并讨论鉴别诊断。20例病例取自艾哈迈达巴德古吉拉特癌症与研究所细胞病理学部门的记录。穿刺涂片用巴氏染色法和/或吉姆萨染色法染色。将细胞学和结构标准应用于穿刺涂片。15例（75%）HBL患者年龄在2岁以下。最常见的表现是腹部肿块。根据细胞结构特征，HBL分为未分化和分化两组。形态学上，肿瘤细胞通常呈腺泡状、乳头状或片状排列。单纯细针穿刺抽吸活检（FNA）细胞学在HBL诊断中有一定局限性。因此，细胞结构结合临床特征、影像学技术和血清甲胎蛋白水平有助于HBL的特异性诊断，并排除小圆形细胞瘤的其他各种鉴别诊断。发现分化型HBL与肝细胞癌（HCC）之间的细胞学鉴别诊断非常困难。
