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What is your interpretation here?
An 81-year-old male with liver lesion on CT. Ultrasound-guided fine needle aspiration.

What is your interpretation here?<br/>
An 81-year-old male with liver lesion on CT. Ultrasound-guided fine needle aspiration.

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Asked by Kguerin, Last updated: Nov 09, 2024

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kguerin

kguerin

kguerin
Kguerin

Answered Sep 13, 2018

Metastatic neuroendocrine tumor

Smears from this needle aspirate are cellular, nearly devoid of normal-appearing hepatocytes, and quite suspicious for malignancy. Sheets and loose groups of cells have a monotonous, plasmacytoid appearance. The nuclei are uniform and round with coarse, speckled chromatin. Ancillary special stains reveal positivity for cytokeratin as well as chromogranin. The cytomorphologic features best fit a neuroendocrine tumor rather than an adenocarcinoma. Small cell carcinoma may be a consideration, but the degree of nuclear pleomorphism, lack of nuclear molding, and level of hyperchromasia do not reach the threshold for this diagnosis. Reference 1.Nicholson SA, Ryan MR. A review of cytologic findings in neuroendocrine carcinomas including carcinoid tumors with histologic correlation. Cancer. 2000;90:148161.
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