Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Background: As the role of PET-FDG imaging is being established in the staging and monitoring of response to therapy in children with lymphoma, we encountered a case of an infection common in adolescence that may present with lymphoma-like signs and symptoms.Methods: A 13-year-old previously healthy male presented with a left neck mass associated with weakness, fatigue, intermittent fevers and weight loss. He was then referred to the hematology/oncology department with a working diagnosis of lymphoma. The total wbc count was 5920/cu mm with 75% lymphocytosis without atypical lymphocytes. ESR was 20 mm. Serologic analysis for EBV, CMV, toxoplasmosis and hepatitis was also performed. The chest x-ray was normal. CT scan demonstrated multiple enlarged lymph nodes in both right and left jugulodigastric and spinal accessory chains; the largest mass within the left spinal accessory chain had focal necrosis within it. There were no enlarged mediastinal or axillary nodes. The spleen was massively enlarged and the splenic index was 924 (normal for age = 744).Results: FDG imaging showed intense uptake in both cervical regions, the mediastinum and in the enlarged spleen. The results of the Monospot test and the EBV panel which were both positive, were available 3 & 5 days later. Based on these serologic results, the history, physical findings and the negative chest x-ray, the final diagnosis was infectious mononucleosis.Conclusion: Despite availability, ease of performance and sensitivity of FDG imaging, this case illustrates the importance of clinical, hematologic and serologic assessment of disease prior to FDG imaging.
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PMID:22. FDG Uptake in Infectious Mononucleosis. 1115 Jul 79

We report here on a case of non-Hodgkin's lymphoma in which liver involvement was the predominant clinical manifestation. A healthy 44-year-old man presented with upper abdominal pain, hepatosplenomegaly, thrombocytopenia, elevated AST, ALT and bilirubin, and marked elevation of lactate dehydrogenase and alkaline phosphatase. The abdominal CT scan showed only diffuse hepatosplenomegaly and uneven contrast enhancement of the spleen without any definite mass of the liver and spleen. US-guided aspiration biopsy of liver and the histologic examination confirmed a diagnosis of non-Hodgkin's lymphoma, the diffuse large B cell type. Bone marrow biopsy showed the infiltration of malignant lymphoma cells. PET-CT showed an increased FDG uptake of the liver, spleen and long bones. The patient was treated with combination regimen of cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy. Even in the absence of a mass lesion or lymphadenopathy, primary hepatic or hepatosplenic lymphoma should be considered in differential diagnosis of hepatitis or liver cirrhosis, especially for patients with diffuse hepatosplenomegaly and markedly elevated LDH.
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PMID:[A case of primary hepatic lymphoma mimicking hepatitis]. 1617 55

A primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) is very rare. We found a solitary mass 27 mm in size in the left lobe of the liver of a 58-year-old Japanese man with a history of hepatitis-C infection. Based on the results of imaging studies, the tumor was diagnosed as a hepatocellular carcinoma (HCC). The left lobe of the liver was lobectomized and microscopic findings showed that the tumor was a hepatic MALT lymphoma, while immunohistochemistry showed it to be positive for CD20 and CD79a. In a fluorodeoxyglucose-positron emission tomography examination integrated with computed tomography scanning (FDG-PET CT) before surgery, the tumor was revealed to have a high standardized uptake value (SUV) for FDG. The patient received chemotherapy after surgery. To the best of our knowledge, 45 cases had been reported with a mean age for all patients of 61.4 years. The pathogenesis remains unclear, although half of the patients had a past history of chronic inflammatory liver disease. Surgical resection was performed in most cases and some patients received postoperative chemotherapy or radiotherapy. The clinicopathologic characteristics and management of this extremely rare disease are also discussed.
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PMID:Primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type: case report and review of the literature. 1880 27

Glycogen storage disease type Ia (GSD-Ia; also called von Gierke disease) is an autosomal recessive disorder of carbohydrate metabolism caused by glucose-6-phosphatase deficiency. There have been many reports describing hepatic tumors in GSD patients; however, most of these reports were of hepatocellular adenomas, whereas there are only few reports describing focal nodular hyperplasia (FNH) or hepatocellular carcinoma (HCC). We report a case with GSD-Ia who had undergone a partial resection of the liver for FNH at 18 years of age and in whom moderately differentiated HCC had developed. Preoperative imaging studies, including ultrasonography, dynamic computer tomography (CT) and magnetic resonance imaging, revealed benign and malignant features. In particular, fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT revealed the atypical findings that FDG accumulated at high levels in the non-tumorous hepatic parenchyma and low levels in the tumor. Right hemihepatectomy was performed. During the perioperative period, high-dose glucose and sodium bicarbonate were administered to control metabolic acidosis. He had multiple recurrences of HCC at 10 mo after surgery and was followed-up with transcatheter arterial chemoembolization. The tumor was already highly advanced when it was found by chance; therefore, a careful follow-up should be mandatory for GSD-I patients as they are at a high risk for HCC, similar to hepatitis patients.
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PMID:Hepatocellular carcinoma and focal nodular hyperplasia of the liver in a glycogen storage disease patient. 2276 70

The potential of (18)F-FDG PET/CT in the diagnosis and treatment response monitoring of fever of unknown origin (resulting from hepatosplenic tuberculosis) is demonstrated in this report. The patient was a 32-y-old woman who had presented to us with a history of pyrexia of unknown origin for the past 2 mo. On investigation, she was found to have hepatic and splenic granulomas, with whole-body (18)F-FDG PET demonstrating abnormal (18)F-FDG-avid foci in the liver and spleen. Ultrasonography-guided liver biopsy was suggestive of granulomatous hepatitis. The patient was clinically nonresponsive to first-line antitubercular drugs, and second-line antitubercular medications were added subsequently in view of clinical nonresponse. The patient responded well to the treatment. The repeated CT scan at 11 mo demonstrated persistence of the splenic granulomas; however, follow-up (18)F-FDG PET/CT at the same time showed resolution of (18)F-FDG-concentrating active disease foci with suggestion of complete metabolic response, commensurate with the patient's clinical improvement.
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PMID:18F-FDG PET and PET/CT in diagnosis and treatment monitoring of pyrexia of unknown origin due to tuberculosis with prominent hepatosplenic involvement. 2494 23

An 18-year-old man was referred to the Internal Medicine ward because of a 2-week history of intermittent high fever, weight loss and cough. Clinical examination revealed hepato-splenomegaly and multiple lymph nodes swelling while laboratory tests showed elevated C-reactive protein, gamma glutamyl transferase and lactate dehydrogenase. All serologic testes for auto-immune antibodies, viruses and bacteria were negative except for Chlamydophila pneumoniae. An 18-FDG PET computed tomography scanner showed hypermetabolism in the liver, spleen and lymph nodes. We therefore conducted a liver biopsy that demonstrated non-necrotizing granulomas. We conclude to a C. pneumoniae infection associated with a granulomatous hepatitis. After treatment with Doxyciclin the patient had no more fever, hepatosplenomegaly resolved and blood testes normalized. This case report is to our knowledge the first report of a granulomatous hepatitis associated with C. pneumoniae respiratory infection.
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PMID:Liver granulomatosis: a case of Chlamydophila pneumoniae infection. 2517 57

A 78-year-old man with metastatic malignant melanoma underwent a restaging 18F-FDG PET/CT after initiation of ipilimumab therapy, a Food and Drug Administration-approved human monoclonal antibody targeting CTLA-4. PET/CT demonstrated intense FDG uptake fusing to poorly circumscribed hypodensities throughout the liver. Patient was experiencing high-grade fever, chills, and generalized fatigue at the time of imaging, as well as mildly elevated liver function tests. Patient was subsequently treated with corticosteroids for suspected ipilimumab-induced hepatitis, and the patient rapidly improved clinically. Follow-up PET/CT 2 months later revealed complete resolution of abnormal FDG uptake in the liver, confirming the diagnosis of ipilimumab-induced hepatitis.
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PMID:Ipilimumab-induced hepatitis on 18F-FDG PET/CT in a patient with malignant melanoma. 2529 Feb 91

A 70-year-old woman with a history of autoimmune hepatitis and renal cell carcinoma presented with subacute cognitive impairment. A brain MRI revealed mild leukoaraiosis, whereas brain F-FDG PET/CT showed diffuse cerebral hypometabolism that resembled some of the patterns described in limbic encephalitis and neurodegenerative diseases. With the suspicion of autoimmune encephalitis, the patient received immunotherapy with dramatic improvement of cognitive function and metabolic normalization at the 2-month follow-up on brain F-FDG PET/CT. Our results demonstrate that brain F-FDG PET/CT might be a useful tool in the assessment of patients with autoimmune encephalitis.
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PMID:Monitoring the Effect of Immunotherapy in Autoimmune Limbic Encephalitis Using 18F-FDG PET. 2605 9

Gastroesophageal junction adenocarcinoma on esophagogastroduodenoscopy biopsy. Initial PET-CT showed no definite evidence of distant metastatic disease. One month after radiation treatment, repeat PET-CT showed interval decrease in size of gastroesophageal mass but new multifocal FDG avidity in the caudate and left hepatic lobes. Correlation with contrast-enhanced CT and US images was negative, making metastasis less likely. Ultrasound-guided biopsy confirmed radiation-induced hepatitis, which caused false positively increased FDG uptake from inflammatory changes.
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PMID:PET-CT Post-Hepatic Radiation Changes in Gastroesophageal Adenocarcinoma. 2774 25

A 26-year-old woman presented with a headache, left-sided weakness of the body, and pulsatile swelling above the sternal notch. She was treated for abdominal tuberculosis in the past, two years later she developed miliary tuberculosis and was put on modified regimen of antitubercular drugs in view of drug induced hepatitis. Ultrasound neck revealed saccular aneurysm measuring 4 x 3 cm, located in between common carotid arteries with an eccentric thrombus. MRI brain revealed multiple tuberculoma with thick basal meningeal enhancement. Cerebrospinal fluid was positive for Mycobacterium tuberculosis. F-FDG PET/CT was done to delineate the extent of the disease.
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PMID:18F-FDG PET/CT of Tuberculosis Meningitis and Carotid Pseudoaneurysm. 2839 36


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