Smears from this needle aspirate are cellular, nearly devoid of normal-appearing hepatocytes, and quite suspicious for malignancy. Sheets and loose groups of cells have a monotonous, plasmacytoid appearance. The nuclei are uniform and round with coarse, speckled chromatin. Ancillary special stains reveal positivity for cytokeratin as well as chromogranin.
The cytomorphologic features best fit a neuroendocrine tumor rather than an adenocarcinoma. Small cell carcinoma may be a consideration, but the degree of nuclear pleomorphism, lack of nuclear molding, and level of hyperchromasia do not reach the threshold for this diagnosis.
Reference
1.Nicholson SA, Ryan MR. A review of cytologic findings in neuroendocrine carcinomas including carcinoid tumors with histologic correlation. Cancer. 2000;90:148161.
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