4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

Clinical Cytology - Oral Presentations
TREATMENT OUTCOMES OF HEPATOCELLULAR CARCINOMA PROVEN BY FINE
NEEDLE ASPIRATION CYTOLOGY: A SINGLE CENTRE EXPERIENCE
Mrzljak A, Čolić Cvrlje V, Kardum-Skelin I, Škegro D, Filipec-Kanižaj T, Šušterčić D
Department of Medicine, University Hospital Merkur, Zagreb, Croatia
Hepatocellular carcinoma (HCC) mostly occurs in chronic liver disease and cirrhosis.
Surgical resection and liver transplantation (LT) represent potentially curative treatments
of choice and if not feasible, palliative strategies such as percutaneous interventional
techniques (PITs) and systemic therapy (ST) are considered. Elevated alfafetoprotein,
typical imaging pattern, needle core biopsy (NCB) and fine needle aspiration
cytology (FNAC) complement diagnostic assessment of HCC.
We have retrospectively analyzed HCC diagnosed by FNAC at our institution from 2004-
2009 regarding treatment options. Ultrasound guided FNAC was performed in cases of
contraindications for NCB. No complications were documented, except for mild transitory
discomfort at the site of puncture. The diagnosis was verified by May-Grunwald-
Giemsa (MGG) staining and immunohistochemistry. In overall of 62 patients, HCC developed
in 61% and 39% in cirrhotic and non-cirrhotic liver, respectively. Underlying cause
of liver disease was alcohol abuse in 32% and viral diseases in 13% of cases. In the setting
of cirrhosis 16% of patients underwent PITs, 18% liver transplantation, 26% ST and
40% symptomatic therapy. In non-cirrhotic patients resection, ST, symptomatic therapy
and PIT were applied in 46%, 25%, 25% and 4%, respectively. Pathohistology of resected
and explanted livers (18 cases) confirmed the initial diagnosis.
Our observations demonstrate that screening of high-risk groups and early identification
of HCC should be addressed more intensely, since only early stage of HCC offers potentially
curative treatment options. FNAC offers minimally invasive, rapid and uncomplicated
diagnostic approach in the setting of abnormal coagulation and ascites commonly
seen in advanced liver disease, providing therefore simple and effective diagnostic tool.
anna.mrzljak@gmail.com
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4 th Croatian Congress of Clinical Cytology / 1 st Croatian Symposium of Analytical Cytology / 2 nd Croatian Symposium of Cytotechnology