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Romanian Journal of Internal Medicine

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Fine Needle Aspiration Biopsy (FNAB) in the Diagnosis of Hepatocellular Carcinoma: A Review

Alexandra Kalogeraki
  • Corresponding author
  • Department of Cytopathology, Medical School, University of Crete, University Hospital, Heraklion, Crete, Greece
  • Email:
/ Georgios Z. Papadakis
  • Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Clinical Center (CC), Bethesda, MD, USA (2)
/ Dimitrios Tamiolakis
  • Department of Cytopathology, Medical School, University of Crete, University Hospital, Heraklion, Crete, Greece
/ Iliana Karvela-Kalogeraki
  • Department of Cytopathology, Medical School, University of Crete, University Hospital, Heraklion, Crete, Greece
/ Mihailos Karvelas-Kalogerakis
  • Department of Cytopathology, Medical School, University of Crete, University Hospital, Heraklion, Crete, Greece
/ John Segredakis
  • Department of Cytopathology, Medical School, University of Crete, University Hospital, Heraklion, Crete, Greece
/ Eleni Moustou
  • Department of Cytopathology, Medical School, University of Crete, University Hospital, Heraklion, Crete, Greece
Published Online: 2015-10-14 | DOI: https://doi.org/10.1515/rjim-2015-0028

Abstract

Hepatocellular carcinoma (HCC) is the fifth more common cause of cancer and the third leading cause of cancer deaths worldwide. Despite advances in surgical and non surgical modalities in the treatment of HCC, a number of controversies regarding appropriate diagnostic procedures continue to evolve. A consensus statement from the European Association for the study of Liver Diseases (EASL) has been formulated to help clinicians standardize diagnostic approaches. In nodules greater than 2 cm diameter in size, diagnosis can be made if any 2 imaging studies (ultrasonography, computed tomography, magnetic resonance imaging or hepatic arteriography) show increased vascularity. Alternatively only one imaging study with an Alpha fetoprotein level more than 400ng/mL is diagnostic. Fine needle aspiration biopsy (FNAB) should be performed in cases of indeterminate radiology and in lesions sized between 1 and 2 cm. The aim of this review is to familiarize pathologists in the FNAB diagnosis of HCC in an appropriate and timely fashion.

Carcinomul hepatocelular (HCC) este a cincea cauză de malignitate şi a treia cauză de mortalitate prin cancer în întreaga lume. În ciuda progreselor obţinute în tehnicile chirurgicale şi non-chirurgicale pentru tratamentul HCC, există încă controverse privind procedurile diagnostice ale acestei afecţiuni. Pentru a facilita standardizarea procedurilor diagnostic a fost realizat un consens al Asociaţiei Europene pentru studiul bolilor hepatice (European Association for the study of Liver-EASL). Pentru nodulii hepatici cu diametrul mai mare de 2 cm diagnosticul poate fi realizat dacă cel puţin două proceduri imagistice (ecografie, tomografie computerizată, rezonanţă magnetică nucleară sau arteriografia hepatică) demonstrează creşterea vascularizaţiei. Alternativ, nivelurile crescute ale alfa-fetoproteinei alături de o evaluarea imagistică poate transă diagnosticul. Aspiraţie fină pe ac (FNAB) trebuie realizată dacă evaluarea imagistică este indeterminată sau dacă leziunile au diametrele între 1 şi 2 cm. Obiectivul acestei lucrări a fost de a prezenta succint aspectele FNAB pentru diagnosticul HCC.

Keywords: Liver; Hepatocellular carcinoma; FNAB; cytology; immunocytochemistry

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About the article

Received: 2015-04-23

Published Online: 2015-10-14

Published in Print: 2015-09-01


Citation Information: Romanian Journal Of Internal Medicine, ISSN (Online) 1220-4749, DOI: https://doi.org/10.1515/rjim-2015-0028. Export Citation

© 2015 Alexandra Kalogeraki et al., published by De Gruyter Open. This chapter is distributed under the terms of the Creative Commons Attribution 4.0 Public License. (CC BY 4.0)

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