[primary and secondary malignant liver tumors at autopsy, biopsy and cytology: frequency and problems of differential diagnosis].

: The frequency and ratio of primary and secondary malignant liver tumours were evaluated in the autopsy, biopsy and cytology files from 1980 to 1994. In 1008 necropsies with hepatic malignancies, 91 primary liver carcinomas and 917 metastatic liver tumours were observed. In a total of 2537 malignant neoplasias at autopsy, the overall-rate of liver metastases amounted to 36%. The four most frequent primary carcinomas of liver metastases found at necropsy were bronchial, colorectal, pancreatic, and breast carcinomas. In 193 liver tumour biopsies, 27 hepatic carcinomas and 160 liver metastases were diagnosed histologically, whereas in 6 biopsies only a differential diagnosis between primary/secondary carcinomas could be made. Histologically, adenocarcinomas were observed in 65% of the liver metastases under biopsy. The four most frequent primaries of hepatic metastases registered at biopsy were colorectal, biliary system, pancreatic, and gastric carcinomas, so that metastasis formation of the portal vein type predominated in the biopsy series with 73% of the cases. In spite of supplementary immunohistological examinations, the primary tumour remained unknown in 13% of the metastases studied at liver biopsy. In 58 fine needle aspirations of clinically suspected liver tumours, 11 hepatocellular carcinomas and 29 liver metastases were found cytologically, whereas 18 specimen showed differential diagnostically inconsistent tumour findings. Gastrointestinal and breast carcinomas were the two most often primaries of liver metastases diagnosed cytologically. The primary/secondary liver tumour ratio amounted to 1:10 at autopsy and shifted to 1:6 in the biopsy series as well as to 1:3 in the cytology material.