Extramedullary hematopoiesis as a ‘clue’ to diagnosis of hepatoblastoma on fine needle aspiration cytology: A report of two cases
A 53-day-old male baby presented with an abdominal mass at birth. Routine investigations showed hemoglobin of 5.6 g% and platelet count of 3.2 lakhs/cu.mm. Computed tomography (CT) scan showed a mixed nonhomogenous mass in the abdomen extending to the abdominal wall, compressing the liver, and reaching up to the bladder []. With a possibility of neuroblastoma, FNAC was performed. Cellular smears showed cells in sheets, trabecular pattern, and occasional rosette formation. The cells exhibited moderate cytoplasm and round nuclei with condensed chromatin; a few cells displayed intracytoplasmic yellowish-green pigment indicating bile. Also seen were a few scattered megakaryocytes and erythroblasts suggesting the evidence of EMH []. In view of these cytologic findings a diagnosis of ‘small round cell neoplasm suggestive of HB was offered, with an advice to correlate with the serum alpha-fetoprotein (AFP) levels. Serum AFP level was elevated to 2000 ng/mL (normal <10 ng).