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It is clinically important to distinguish primary liver cancer from metastasis. We sometimes have difficulty in deciding the primary source of the liver cancer by ordinary Papanicolaou and/or Giemsa staining, especially in the case of adenocarcinoma. In order to decide primary source of the liver cancer, cytological examination by amino acid naphthylamidase staining (N-ase staining) was performed in four cases of cholangicarcinoma, various metastatic liver cancers (seven due to gallbladder cancer, one choledochus, five pancreas, 12 stomach and four colon cancers) and these primary lesions, making up 33 cases as sum total.Results are as follows: In all cases of cholangiocarcinoma, cytoplasm was evenly stained as lots of granular dots with red-brown color, but bile canaliculi like structure were not found. In all cases of metastatic liver cancer from choledochal and gallbladder cancer, the stained dots were found in the cytoplasm making a crescent form. In all cases of metastatic liver cancer from pancreatic, gastric and colonic cancer, these staining characteristics were found to be lacking. In all cases of primary lesions of these metastatic liver cancer, the staining was shown same cytologic findings.In conclusion, cytological examination using N-ase staining is valiable to differentiate cholangiocarcinoma from metastatic liver cancer and to differenciate cholangiocarcinoma from metastatic liver cancer of biliary tract cancer.
財団法人日本消化器病学会の論文

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