Cytopathology Features

The cytologic features of the patient’s liver FNA showed cellular pleomorphism, consisting of atypical spindle cells arranged singly and in small clusters in a background of acute inflammation. The cells had round, ovoid or cigar shaped nuclei exhibiting irregular nuclear membranes, coarse chromatin and prominent nucleoli and scant to moderate, elongated, wispy or feathery cytoplasm. Immunohistochemistry (IHC) was performed on multiple cuts of the liver core biopsy which stained positive for vascular markers (CD31, CD34, ERG and D2-40) and negative for hepatocytic markers (Glypican-3 and Arginase).