Background: Bile cytology from percutaneous transhepatic cholangio-drainage (PTCD) is a useful procedure in case of obstructive jaundice.
Case: Repeated cytology via PTCD from a cystically dilated duct in a 56-year-old female with a long clinical history permitted a diagnosis of squamous cell carcinoma (SCC). The smears showed excessive benign-appearing squamous cells with or without a nucleus and a few keratinized- and nonkeratinized-type SCC cells. No adenocarcinoma-derived cells were identified. No focus of SCC was detected clinically. The resected hepatic specimen disclosed a keratinized-type SCC simultaneous with benign metaplastic squamous epithelium.
Conclusion: This case of cytology of primary SCC of the liver seems to be the first reported. Even when showing a great number of benign-appearing squamous cells, the possibility of malignancy should not be ruled out. Repeating the cytology from PTCD is effective for a diagnosis.