Background: Ciliated hepatic foregut cysts, albeit rare, are important to consider in liver aspirates obtained for evaluation of possible neoplastic disease.
Cases: In three cases, liver fine needle aspirates showed features consistent with ciliated hepatic foregut cysts. Two of these aspirates were obtained to evaluate possible metastatic disease prior to resection of primary tumors, one of the lung and one of the bladder. A third case had radiologic findings suggestive of a cystic neoplasm. The fine needle aspirate material from these cases revealed clusters of tall, columnar cells with basally oriented nuclei and prominent apical terminal plates with cilia. These features are consistent with ciliated hepatic foregut cysts.
Conclusion: This entity, although originally described in the late 19th century, to our knowledge has not been reported to occur in fine needle aspirate material and should be included in the differential diagnosis of cystic lesions of the liver.