BACKGROUND: The incidence of hepatocellular carcinoma (HCC) is steadily increasing in western countries. Its present incidence in Italy is about 6.9/100,000. The diagnosis is usually made by a combination of ultrasound (US), computed tomography (CT) and fine needle aspiration biopsy (FNAB). HCC resembling a neuroendocrine tumor has been described, but no previous FNAB diagnosis was reported. CASE: An asymptomatic 45-year-old man underwent a CT scan after incidental US detection of multiple focal lesions in both lobes of the liver. FNAB showed clusters of small neoplastic cells with hyperchromatic nuclei and scanty cytoplasm. A thin tissue core showed a microacinar pattern very similar to that of a neuroendocrine tumor. A large panel of specific antibodies displayed an immunophenotype consistent with HCC. CONCLUSION: In this rare variant of HCC, the final diagnosis could be assessed only by correlating the cytologic, microhistologic and immunohistochemical features.
BACKGROUND: The incidence of hepatocellular carcinoma (HCC) is steadily increasing in western countries. Its present incidence in Italy is about 6.9/100,000. The diagnosis is usually made by a combination of ultrasound (US), computed tomography (CT) and fine needle aspiration biopsy (FNAB). HCC resembling a neuroendocrine tumor has been described, but no previous FNAB diagnosis was reported. CASE: An asymptomatic 45-year-old man underwent a CT scan after incidental US detection of multiple focal lesions in both lobes of the liver. FNAB showed clusters of small neoplastic cells with hyperchromatic nuclei and scanty cytoplasm. A thin tissue core showed a microacinar pattern very similar to that of a neuroendocrine tumor. A large panel of specific antibodies displayed an immunophenotype consistent with HCC. CONCLUSION: In this rare variant of HCC, the final diagnosis could be assessed only by correlating the cytologic, microhistologic and immunohistochemical features.