2018 Volume 57 Issue 5 Pages 259-266
Background : We report a rare case of detection of two different types of cancer cells on bile cytology.
Case : A 63-year-old male patient had undergone resection for hepatocellular carcinoma at the age of 56. Bile cytology was performed five times and bile duct brush cytology was also performed, because abdominal CT revealed dilatation of the left intrahepatic bile duct. The first bile cytology and bile duct brush cytology revealed many large tumor cells dispersed or arranged in clusters of various sizes. The tumor cells had abundant clear and vacuolated cytoplasm and small round nuclei, and were immunocytochemically positive for Hepatocyte and negative for CK 7 (Hepatocyte (+) and CK 7 (−) ). The fifth bile cytology showed a few tightly packed clusters of tumors cells with irregular outlines. The tumor cells were medium-sized, with scant cytoplasm and irregularly shaped nuclei and dense chromatin ; immunocytochemically, they were negative for Hepatocyte, but positive for CK 7 (Hepatocyte (−) and CK 7 (+) ). Autopsy examination revealed a hepatocellular carcinoma invading the bile duct and carcinoma in situ of the pancreas.
Conclusion : Bile cytology in this case showed two different types of cancer cells―one arising from hepatocellular carcinoma and the other from pancreatic cancer.
