Liver and Bile Duct: Practice Question

FNA of a liver lesion shows fragments of hepatocytes, some with prominent nucleoli and binucleation, and bile ductules. The differential diagnosis includes all of the following EXCEPT:
  1. Hepatic adenoma
  2. Focal nodular hyperplasia
  3. Normal liver
  4. Regenerative nodule of cirrhosis
Show Answer and Explanations

Hepatic adenoma — Correct answer

Correct. Presence of bile ductules rules out hepatic adenoma.

Focal nodular hyperplasia

Incorrect. These features can be seen in focal nodular hyperplasia.

Normal liver

Incorrect. These features can be seen in normal liver

Regenerative nodule of cirrhosis

Incorrect. These features can be seen in regenerative nodules of cirrhosis.

Summary

Summary: A liver FNA showing cytologically normal hepatocytes could be normal liver, a cirrhotic regenerative nodule, hepatic adenoma or focal nodular hyperplasia. Bile ductules are not seen in hepatic adenoma.
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