Hepatobiliary cytology Flashcards
Which liver diseases are more accurately diagnosed with a wedge biopsy than tru-cut (aka need more tissue)?
hepatitis/cirrhosis
fibrosis
cholangitis
portovascular anomaly
What value is important to check prior to aspiration of liver?
PLT
For which type of liver diseases is FNA of the liver good?
Diffuse diseases
hepatic lipidosis, vacuolar hepatopathy, lymphoma, neutrophilic hepatitis
For which type of liver diseases is an FNA not good?
Focal diseases
lymphocytic inflammation, fibrosis, cirrhosis, portovascular anomalies, focal mass, early mets
Based on the diagram shown, why is it that FNA can be a good screening tool but cannot for sure tell that a lesion is neoplastic vs. hyperplastic?
could sample hyperplastic area but not neoplastic region
What cells are shown in the picture?
Are the black granules normal?
Liver cells (hepatoid in shape, coarse chromatin, single nucleoli)
granules are normal
Normal or abnormal?
normal nuclear crystals can be seen
Liver cells or biliary epithelium?
biliary epithelium
Are low #’s of mast cells normal to see in the liver?
YES
Type of vacuolization?
Level of severity?
DX?
distinct (accumulation of fat)
severe
hepatic lipidosis
This cytology is observed in the liver of a dog. What are the two most common causes?
pancreatitis & diabetes
Classify this liver aspirate.
What is accumulating?
In which species is this more common?
Indistinct vacuolization
glycogen or water accumulation
dogs
Describe the type of vacuolization in this liver cytology.
The degree of severity?
Name the two common causes of this?
Indistinct vacuolization
severe
(glycogen accumulates out of cell and squishes with nuclei and cytoplasm- makes middle dark)
steroid use or Cushing’s
What condition often results from severe vacuolization?
cholestasis from blockage of the bile canniculi
What is the pigment accumulating in the liver cells?
Cause?
Bile (cholestasis) or lipofuscin (wear and tear pigment, normal with age)
What change in the liver can be observed before there are changes in liver enzymes?
What does it indicate?
Bile casts (in black)
indicates cholestasis
why is it difficult to determine cholangitis from hepatitis with cytology?
Tissue architecture not preserved
What type of inflammation can be reliably detected with liver cytology?
neutrophilic inflammation
In felines, what is the major difference between lymphocytic inflammation and lymphoma?
lymphoma often diffuse with a large liver
lymph inflammation often periportal and low #
Can lymphoma be dx on cytology of the liver in a feline?
No, need tissue architecture
What conditions could possibly result in a false + inflammation dx in the liver cytology?
leukocytosis
extramedullary hematopoiesis
Leukemia
abdominal effusion
Classify this liver cytology.
hyperplasia
(Increase in binucleation, anisokaryosis, pleomorphism
Hard to ddx from neoplasia***)
What are the characteristics associated with nodular hyperplasia compared to regenerative nodules in the liver?
nodular hyperplasia: vacuoles, pigment, EMH (idiopathic, older dogs, incr. ALP, no C.S.)
regenerative: bile pigment in vacoules, bile casts evidence of cholestasis,
Metastatic neoplasia is more common in the liver than primary neoplasia. T/F?
TRUE
Which is more common in dogs vs. cats— hepatocellular or biliary neoplasia?
dogs: hepatocellular
cats: biliary
What is the most commonly dx liver neoplasm?
lymphoma
Is hepatocellular carcinoma more commonly diffuse in the liver or focal mass?
DIFFUSE
Classify this liver cytology.
Neoplastic, anaplastic carcinoma
Classify this liver cytology.
Bile duct carcinoma
Classify this liver cytology.
Lymphoma
