Cytologie hépatique Flashcards
FNA du foie
Hépatocytes normaux
Hepatocytes have abundant granular cytoplasm, a round and regular nucleus (or two), and a prominent nucleolus. They are arranged as a ribbon of two cells’ width. Lipofuscin, the normal “wear and tear” pigment, is present (arrow) (Papanicolaou stain).
FNA du foie
Hépatocytes normaux
Lipofuscin appears greenish with the Romanowsky stains. A pseudoinclusion is present (Romanowsky stain).
FNA du foie
Patient cirrhotique
Bile
Bile pigment is not usually seen unless there is bile stasis. With the Romanowsky stains, bile pigment is a dense, dark greenish-black pigment in the cytoplasm of hepatocytes (arrow). This case is from a patient with cirrhosis (Romanowsky stain).
FNA du foie
Stéatose
This patient had a long-standing history of alcohol abuse, and diffuse nodularity was noted on computed tomography. Fine-needle aspiration demonstrated abundant fatty changes (Papanicolaou stain).
FNA du foie
Kyste hydatide
(B) Rarely, an intact scolex and numerous hooklets are identified (Papanicolaou stain).
FNA du foie
Hémangiome
(A) Smears show occasional tangles of spindle-shaped cells that are difficult to classify (Papanicolaou stain).
FNA du foie
Carcinome hépatocellulaire pauvrement différencié
(B) Poorly differentiated tumors show little if any hepatocellular differentiation; they resemble poorly differentiated cholangiocarcinomas and metastatic carcinomas (Papanicolaou stain).
FNA du foie
Carcinome hépatocellulaire
A markedly cellular preparation with abundant naked nuclei is characteristic of many hepatocellular carcinomas (Romanowsky stain).
FNA du foie
Carcinome hépatocellulaire type trabéculaire
(A) Thick (>2 cells across) trabeculae are a characteristic feature of the classic hepatocellular carcinoma with a prominent trabecular pattern. Note the increased nuclear-to-cytoplasmic ratio of the neoplastic hepatocytes and the flat endothelial cells with spindle-shaped nuclei that wrap the trabeculae (Papanicolaou stain).
FNA du foie
Carcinome hépatocellulaire type trabéculaire
(A) Thick (>2 cells across) trabeculae are a characteristic feature of the classic hepatocellular carcinoma with a prominent trabecular pattern. Note the increased nuclear-to-cytoplasmic ratio of the neoplastic hepatocytes and the flat endothelial cells with spindle-shaped nuclei that wrap the trabeculae (Papanicolaou stain).
FNA du foie
Carcinome hépatocellulaire type acinaire
The cords of neoplastic cells are arranged in acini. Note the increased nuclear-to-cytoplasmic ratio, a key feature in the diagnosis of hepatocellular carcinoma (Papanicolaou stain).
FNA du foie
Carcinome hépatocellulaire
Prominent transgressing vessels are characteristic of hepatocellular carcinoma (Papanicolaou stain).
FNA du foie
Hépatocytes avec bile (carcinome hépatocellulaire, mais je pense pas qu’on peut le dire ici)
FNA du foie
Carcinome hépatocellulaire pauvrement différencié
A, Bizarre, atypical forms including spindle cells with intracytoplasmic globules are noted (smear, Romanowsky stain).
FNA du foie
Carcinome hépatocellulaire variante à cellules claires
(A) As with many hepatocellular carcinomas, abundant bare nuclei are present. The cells have been disrupted, and the abundant spilled cytoplasmic glycogen gives a mottled appearance to the background that is reminiscent of the “tigroid” background seen with another glycogen-rich tumor, the seminoma (see Fig. 2.48) (Romanowsky stain).
FNA du foie
Carcinome hépatocellulaire, changement adipeux
The malignant cells are distended by sharply outlined, large fat vacuoles (Romanowsky stain).
FNA du foie
Carcinome hépatocellulaire, changement adipeux
The malignant cells are distended by sharply outlined, large fat vacuoles (Romanowsky stain).
FNA du foie
Carcinome hépatocellulaire variante fibrolamellaire
(A) Large, atypical hepatocytes are accompanied by fibrous tissue. (B) The malignant cells have abundant granular cytoplasm and intracytoplasmic hyaline globules (arrows) (Papanicolaou stain).
FNA du foie
Carcinome hépatocellulaire variante fibrolamellaire
(A) Large, atypical hepatocytes are accompanied by fibrous tissue. (B) The malignant cells have abundant granular cytoplasm and intracytoplasmic hyaline globules (arrows) (Papanicolaou stain).
FNA hépatique
Cholangiocarcinome
(A) The tumor cells are in crowded sheets. Haphazard cellular arrangement and glandular differentiation are apparent (Papanicolaou stain). (B) Anisonucleosis and nuclear membrane irregularity are present (Romanowsky stain).
FNA du foie chez une enfant de 7 mois
Hépatoblastome
FNA du foie
Carcinome colique métastatique
The columnar, picket-fence arrangement is apparent on smears as well. Nuclei are enlarged and ovoid (smear, Papanicolaou stain).
FNA du foie
TNE métastatique
FNA du foie
SCNEC
(A) Note the abundant small blue cells with scant cytoplasm and pronounced molding. Nuclear crush artifact is prominent (Romanowsky stain).
FNA du foie
SCNEC
(B) The cells are isolated and arranged in loosely cohesive clusters. The nuclear-to-cytoplasmic ratio is very high, nuclear molding is seen, and the chromatin is finely granular without nucleoli (Papanicolaou stain).
FNA du foie
Mélanome métastatique
FNA du foie
GIST
(A) There are cohesive groups of spindle-shaped cells. Nuclear atypia is minimal in this case (Papanicolaou stain).
