安田 宏, 椎名 秀一朗, 田川 一海, 鵜沼 直雄

Hiroshi YASUDA, Syuichiro SHIINA, Kazumi TAGAWA, Tadao UNUMA

三井記念病院消化器センター内科

Department of Gastroenterology, Mitsui Memorial Hospital

キーワード : Hepatocellular carcinoma, Ultrasound guidance, Small liver cancer

Ultrasonically (US) guided fine-needle aspiration cytology was performed on 60 cases of hepatocellular carcinoma (HCC). Carcinoma calls were obtained by aspiration cytology in 50 of 60 patients (83%). One case died within 24 hours after aspiration. Autopsy revealed intraperitoneal hemorrhage of about 200 ml. The cause of death was not clear.
14 of these were solitary and small (smaller than 2 cm in diameter) HCC and 8 of these were resected later. The detection rate of small HCC was 14/14 by US, 7/14 by angiography, 3/12 by CT. Cytological diagnosis was made in 12/14. There were many cases of small HCC that can be diagnosed only by US and aspiration cytology.
The diagnosis of HCC and the histological grading of them are possible with cytology. But differential diagnosis between well differentiated HCC and benign nodules such as adenomatous hyperplasia is very difficult. And there's few characteristic cytomorphologic feature of HCC in cases of poorly differentiated HCC.
US guided aspiration cytology is reliable method and the primary indication is to document the presence of small HCC.