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An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration
The differential diagnosis of perigastric masses is broad, ranging from benign to malignant entities. Among the benign entities, accessory liver lobes and ectopic liver are unusual and often incidentally discovered. Here, we report a patient with malignant melanoma who was clinically suspected to ha...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5200975/ https://www.ncbi.nlm.nih.gov/pubmed/28105065 http://dx.doi.org/10.4103/1742-6413.196239 |
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author | Barazza, Gonzalo Adler, Douglas G. Factor, Rachel E. |
author_facet | Barazza, Gonzalo Adler, Douglas G. Factor, Rachel E. |
author_sort | Barazza, Gonzalo |
collection | PubMed |
description | The differential diagnosis of perigastric masses is broad, ranging from benign to malignant entities. Among the benign entities, accessory liver lobes and ectopic liver are unusual and often incidentally discovered. Here, we report a patient with malignant melanoma who was clinically suspected to have a perigastric metastasis or a gastrointestinal stromal tumor but was ultimately diagnosed by fine needle aspiration (FNA) to have benign ectopic liver. A 47-year-old male was diagnosed with malignant melanoma of the scalp in May 2015 at a tertiary care hospital. He was found to have a 2.6 cm enhancing mass adjacent to the fundus of the stomach and below the diaphragm by computed tomography imaging. To exclude metastasis, the patient was referred to endoscopy, and an endoscopic ultrasound-guided FNA was performed with rapid on-site evaluation (ROSE) by a cytopathologist. A relatively new FNA needle (Shark Core) was used, which produced useful core biopsy material. Cytopathology demonstrated flat sheets, single cells, and small clusters of polygonal cells. There was abundant granular cytoplasm, often containing pigment. Cells lacked pleomorphism. The smear findings appeared consistent with hepatocytes. The cell block demonstrated small core fragments of hepatic parenchyma with portal tracts. Immunohistochemistry for arginase-1 confirmed that this was hepatic tissue. ROSE was useful for communicating with the endoscopist that the mass was both far from, and not connected to, the liver. This is the first documented account of perigastric ectopic liver diagnosed by FNA. This entity should be considered in the differential of perigastric masses. |
format | Online Article Text |
id | pubmed-5200975 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-52009752017-01-19 An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration Barazza, Gonzalo Adler, Douglas G. Factor, Rachel E. Cytojournal Case Report The differential diagnosis of perigastric masses is broad, ranging from benign to malignant entities. Among the benign entities, accessory liver lobes and ectopic liver are unusual and often incidentally discovered. Here, we report a patient with malignant melanoma who was clinically suspected to have a perigastric metastasis or a gastrointestinal stromal tumor but was ultimately diagnosed by fine needle aspiration (FNA) to have benign ectopic liver. A 47-year-old male was diagnosed with malignant melanoma of the scalp in May 2015 at a tertiary care hospital. He was found to have a 2.6 cm enhancing mass adjacent to the fundus of the stomach and below the diaphragm by computed tomography imaging. To exclude metastasis, the patient was referred to endoscopy, and an endoscopic ultrasound-guided FNA was performed with rapid on-site evaluation (ROSE) by a cytopathologist. A relatively new FNA needle (Shark Core) was used, which produced useful core biopsy material. Cytopathology demonstrated flat sheets, single cells, and small clusters of polygonal cells. There was abundant granular cytoplasm, often containing pigment. Cells lacked pleomorphism. The smear findings appeared consistent with hepatocytes. The cell block demonstrated small core fragments of hepatic parenchyma with portal tracts. Immunohistochemistry for arginase-1 confirmed that this was hepatic tissue. ROSE was useful for communicating with the endoscopist that the mass was both far from, and not connected to, the liver. This is the first documented account of perigastric ectopic liver diagnosed by FNA. This entity should be considered in the differential of perigastric masses. Medknow Publications & Media Pvt Ltd 2016-12-20 /pmc/articles/PMC5200975/ /pubmed/28105065 http://dx.doi.org/10.4103/1742-6413.196239 Text en Copyright: © 2016 Barazza, et al.; Licensee Cytopathology Foundation Inc. http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Barazza, Gonzalo Adler, Douglas G. Factor, Rachel E. An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration |
title | An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration |
title_full | An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration |
title_fullStr | An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration |
title_full_unstemmed | An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration |
title_short | An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration |
title_sort | unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5200975/ https://www.ncbi.nlm.nih.gov/pubmed/28105065 http://dx.doi.org/10.4103/1742-6413.196239 |
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