Fine needle aspiration cytology of hepatobiliary cystadenoma with mesenchymal stroma

• Published in: Cancer 2002-02, Vol.96 (1), p.37-42
• Main Authors: Logroño, Roberto, Rampy, Bill A., Adegboyega, Patrick A.
• Format: Article
• Language: English
• Subjects: biliary ducts; Biliary Tract Neoplasms - pathology; Biological and medical sciences; Biopsy, Needle; Cystadenoma - pathology; cytology; Diagnosis, Differential; Digestive system; Female; fine needle aspiration; hepatobiliary cystadenoma; Humans; Inflammation; Investigative techniques, diagnostic techniques (general aspects); liver; Liver Neoplasms - pathology; Medical sciences; mesenchymal stroma; Mesoderm - pathology; Middle Aged; Pain - etiology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Stromal Cells - pathology
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.10315

BACKGROUND Hepatobiliary cystadenomas (HBCs) with mesenchymal stroma (MS) are rare cystic neoplasms occurring exclusively in women. Hepatobiliary cystadenoma consists of a mucin‐producing cyst lining epithelium underlined by a dense MS cell layer. In the current study, the authors review the fine needle aspiration cytology of HBC with MS and identify characteristic cytologic features that suggest such an uncommon neoplasm on aspirates. METHODS A search of the histopathology files at the University of Texas Medical Branch at Galveston for the interval of January 1992 through December 2000 yielded four cases of HBC having both cytologic and histologic specimens. The cytologic features of the aspirates were reviewed and correlated with the clinical history, radiologic findings, and the histopathology of the excised specimens. RESULTS All four patients were middle‐aged women (mean age, 48.5 years) who presented with epigastric pain radiating to the back, due to large cystic lesions in the right liver lobe (three patients) or the left liver lobe (one patient). Aspiration cytology revealed chronic inflammatory exudate in all cases, along with occasional aggregates of bland, cuboidal‐columnar epithelial cells (in three cases), which rarely arranged in papillary clusters. No significant atypia, evidence of malignancy, or MS cells were identified on the aspirates. HBC with MS was confirmed histologically on the excised specimens in all cases. CONCLUSIONS By ensuring adequate sampling and correlating with consistent clinical and radiologic findings, a diagnosis of HBC or cystic hepatobiliary neoplasm can be suggested on the basis of aspiration cytology. Cancer (Cancer Cytopathol) 2002;96:37–42. © 2002 American Cancer Society. DOI 10.1002/cncr.10315 The cytologic features of hepatobiliary cystadenoma with mesenchymal stroma were described. Aspirated fluid is often hypocellular. However, with adequate sampling and correlation with consistent clinical and radiologic findings, the cytomorphology of this tumor is suggestive of hepatobiliary cystadenoma or, more appropriately, of cystic hepatobiliary neoplasm.