ABSTRACT
Cytologic evaluation of the liver is generally pursued to confirm and define suspected hepatic disease or screen for hepatic metastasis during staging of cancer. Fine needle aspiration of the liver can usually be performed without sedation or local or general anesthesia. Cytologically, hepatocytes are generally found in cohesive clusters and are the predominant cell type other than red blood cells in a liver aspirate. Glycogen accumulation and hydropic change associated with loss of water regulation are two vastly different processes. Cytologically, however, both are noted as a fine, often foamy and indistinct cytoplasmic rarefaction. Copper accumulation, while rarely observed, is noted as a blue–green to gray crystalline material on cytology with Wright–Giemsa staining. Increased numbers of cytologically normal biliary epithelium cells are suggestive of cholestasis and biliary hyperplasia. Cytologically, neoplastic biliary epithelium commonly looks benign, irrespective of its actual clinical course.
