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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A combined cytologic and histologic study of 149 needle-biopsy specimens of liver tissue was done. These specimens represented a wide range of normal and pathologic conditions. Malignancy was demonstrated in 27 cases--18 by both methods of study, one by histologic study alone, and eight by cytologic study alone. In the last group of eight, four were considered conclusive for malignancy and four were suspicious. These results confirm the findings of others who also report the advantages of combined cytologic and histologic study of needle-biopsy specimens for diagnosing malignancy. Similar results have been obtained with cytologic study of fine-needle aspirates. The commonly occurring cytologic findings in liver specimens are presented with a brief discussion of the specificity of the cytologic diagnosis of hepatocarcinoma.
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PMID:Clinical cytology of the liver. 16 39

Aspiration-biopsies under ultrasound guidance, using a fine needle (external diameter inferior to 1 mm) have been performed in 61 malignant hepatic tumors (group I) and 25 pancreatic carcinomas (group II). Malignancy was diagnosed in 83 p. 100 cases; in group I, the sensitivity is 87 p. 100; the difference between hepatocellular carcinoma and liver metastases could be made in 88 p. 100 cases and in case of metastases, the site of the primitive carcinoma could be suggested in 77 p. 100 cases. In group II, the sensitivity is 72 p. 100. No complications were noted.
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PMID:[Sensitivity of fine-needle puncture-biopsy in the histologic diagnosis of hepatic and pancreatic malignant tumors]. 298 74

The longitudinal (T1) and transverse (T2) proton (1H) nuclear magnetic resonance (NMR) relaxation times of pathological human and animal tissues in the frequency range 1-100 MHz are archived, reviewed, and analyzed as a function of tissue of origin, NMR frequency, temperature, species, and in vivo versus in vitro status. T1 data from specific disease states of the bone, brain, breast, kidney, liver, muscle, pancreas, and spleen can be characterized by simple dispersions of the form T1 = AvB in the range 1-100 MHz with A and B empirically determined pathology-dependent constants. Pathological tissue T2 values are essentially independent of NMR frequency. Raw relaxation data, best-fit T1 parameters A and B, and the mean T2 values, are tabulated along with standard deviations and sample size to establish the normal range of pathological tissue relaxation times applicable to NMR imaging or in vitro NMR examination. Statistical analysis of relaxation data, assumed independent, reveals that most tumor and edematous tissue T1 values and some breast, liver, and muscle tumor T2 values are significantly elevated (p greater than or equal to 0.95) relative to normal, but do not differ significantly from other tumors and pathologies. Statistically significant abnormalities in the T1 values of some brain, breast, and lung tumors, and most pathological tissue T2 values could not, however, be demonstrated in the presence of large statistical errors. Both T1 and T2 in uninvolved tissue from tumor-bearing animals or organs do not demonstrate statistically significant differences from normal when considered as a group, suggesting no appreciable systemic effects associated with the presence of tumors compared to the statistical uncertainty. Statistical prediction analysis for both T1 and T2 indicates that of all the tissues studied, only liver hepatoma can be reliably distinguished from normal liver based on a single T1 measurement (p greater than or equal to 0.95) given the scatter in the current published data. Indeed, data scatter, not easily attributable to temperature, species, in vivo versus in vitro status, the inclusion of implanted or chemical induced tumors, or the possible existence of multiple component relaxation, is recognized as the major factor inhibiting the diagnostic utility of quantitative NMR relaxation measurements. Malignancy indexes that combine T1 and T2 data as a diagnostic indicator suffer similar problems of uncertainty. The literature review reveals a dearth of information on the temperature and frequency dependence of pathological tissue relaxation and the possible existence of multiple relaxation components.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A review of 1H nuclear magnetic resonance relaxation in pathology: are T1 and T2 diagnostic? 303 39

An analysis of surgical deaths over a seven-year period (1975-1981) at Port Moresby General Hospital is reported. Malignancy is the leading cause of death, followed by trauma. Hepatoma appears to be the commonest malignancy. 52% of septicaemic deaths occurred due to abdominal sepsis arising mainly due to delayed presentation of acute abdominal catastrophes. A plea for a separate Burns Unit is made, to reduce deaths from burn sepsis.
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PMID:Review of surgical mortality. 658 93

A case is reported in which a large hepatoma presented with rupture and acute severe lactic acidosis. Spontaneous rupture is a rare but recognised mode of presentation of hepatoma. Malignancy has also occasionally been associated with acute lactic acidosis, though the association with hepatoma has not previously been reported.
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PMID:Ruptured hepatoma presenting with peritonitis and acute lactic acidosis. 928 74

The aim of this study was to determine the accuracy of contrast-enhanced biphasic spiral CT as a screening tool in the preoperative evaluation of orthotopic liver transplant (OLT) patients. Spiral-CT examinations were performed before liver transplantation in 53 patients. Scans were retrospectively reviewed and compared with pathologic findings in fresh-sectioned livers. When findings between spiral CT and pathology were discordant, formalized livers were reexamined with lesion-by lesion evaluation. Fresh pathologic evaluation revealed 23 liver lesions (16 HCC, 7 macro-regenerative nodules). Malignancy was identified in 13 of 53 patients (24.5%). Pre-transplantation spiral CT depicted 27 liver lesions (23 HCC, 4 macro-regenerative nodules). Malignancy was suspected in 14 patients (26.4%). In 10 of 53 (18.9%), spiral CT and pathologic evaluation were discordant. Subsequent retrospective pathologic evaluation showed malignancy in 4 additional patients. Spiral CT compared with the retrospective pathologic findings revealed 36 real-negative, 14 real-positive, 0 false-positive, and 3 false-negative patients with malignancy. Sensitivity and specificity of spiral CT in detection of malignancy was 82 and 100%, respectively. Contrast-enhanced biphasic spiral CT is an accurate technique in the evaluation of patients preceding OLT. Routine fresh-sectioned liver pathologic findings are not as sensitive as previously estimated.
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PMID:Malignant focal hepatic lesions complicating underlying liver disease: dual-phase contrast-enhanced spiral CT sensitivity and specificity in orthotopic liver transplant patients. 1151 82

Malignant neoplasm has become the leading cause of death in Taiwan since 1982. There has been a decreasing trend for cancers of the stomach and cervix uteri, while an increasing trend has been observed for cancers of the lung, liver, oral cavity, colon and rectum, breast and prostate. International comparison and migrant studies have shown an elevated risk of hepatocellular carcinoma, nasopharyngeal carcinoma and cervical neoplasia in Taiwan. The national hepatitis B vaccination program, started in July 1984, has resulted in a significant decrease in childhood hepatocellular carcinoma in Taiwan. A decrease in prevalence of cigarette smoking has been observed among middle-aged men since the control of tobacco hazards was enacted in 1997. Free mass screening of cervical neoplasia and colorectal cancer has been implemented in the national health insurance program since 1995. Project-based screening for hepatocellular carcinoma, nasopharyngeal carcinoma and breast cancer among high-risk groups was started in 1994. Most cancer patients are diagnosed by pathological examinations and treated by surgical operation, chemotherapy and radiotherapy in major teaching hospitals in Taiwan. The Taiwan Collaborative Oncology Group has been organized to assess the efficacy of various treatment modalities through multicentric clinical trials. There has been a striking increase in expenditure for medical care of cancer patients. Cancer researchers mainly sponsored by the National Science Council and Department of Health are engaged in basic, epidemiological and clinical studies on major cancers in Taiwan. Major fields of the research include cancer genomics, gene therapy, molecular epidemiology and DNA vaccine.
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PMID:Cancer epidemiology and control in Taiwan: a brief review. 1195 80

Older age is not considered a contraindication for liver transplantation, but age-related morbidity may be a cause of mortality. Survival and the incidence of the main post-transplant complications were assessed in 111 adult liver transplant recipients. They were divided in two groups according to their age (patients younger than 60 years, n=54; patients older than 60 years, n=57) and both groups were compared. Older patients were more frequently transplanted for hepatitis C (p= 0.03) and hepatocellular carcinoma (p= 0.05) and their liver disease was less advanced (Child-Pugh and MELD scores were significantly lower; p=0.004 and p=0.05, respectively). After transplantation, older patients had a significantly lower survival (p=0.02). Higher age was independently associated with mortality (hazard ratio for each 10-year increase: 2.1; 95% confidence interval: 1.1- 4.0; p=0.02). The incidence of de novo neoplasia and nonskin neoplasia were higher in older patients (p=0.02 and p =0.007, respectively). Malignancy was the cause of death in one patient younger than 60 years and in 12 patients older than 60 years (p =0.002). In multivariate analysis, a higher age and smoking were independently associated with a higher risk of dying of de novo neoplasia. In conclusion, older liver transplant recipients have a significantly lower survival than younger patients. Malignancy is responsible for this decreased survival.
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PMID:Liver transplant recipients older than 60 years have lower survival and higher incidence of malignancy. 1452 2

Orthotopic liver transplantation (OLT) is increasingly being applied for cure in patients with cirrhosis and concomitant hepatocellular carcinoma (HCC). In recipients with limited tumor burden, OLT achieves reasonable long-term outcome. This study sought to identify clinical and pathologic variables predictive of long-term disease-free survival and the presence of vascular invasion. From 1992 to 2006, 130 patients underwent OLT for cirrhosis and HCC. Malignancy was diagnosed in 107 patients prior to OLT and in 23 patients on pathologic examination of the explant. Nine clinical and pathologic variables were considered including: TNM stage, nodularity, vascular invasion, Milan criteria, incidental lesion, differentiation, tumor size, preOLT transarterial chemoembolization (TACE), and administration of sirolimus-based immunosuppression. The overall incidence of HCC recurrence was 17% with the majority (82%) being stage III. Cumulatively, tumor recurrence-free survival (RFS) is 84, 74, and 67% at 1, 3, and 5 years respectively. Independent predictors of RFS included stage III and poorly differentiated lesions (P<0.05). Furthermore, stage III tumors and those >3.5 cm in size were predictive of vascular invasion. Importantly, preOLT, TACE and postOLT sirolimus had no influence on survival. Pathologic variables including tumor stage and grade have a significant impact on outcome. Importantly, it seems that TACE and sirolimus had no beneficial effect.
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PMID:Predictors of long-term outcome following liver transplantation for hepatocellular carcinoma: a single-center experience. 1756 79

The Malignancy in Haemophilia Workshop Group convened a consensus working group of haematologists and oncologists to review topics related to malignancy in haemophilia. The treatment of malignant disease in this population is increasingly relevant as both outcome and lifespan continue to improve. Although adequate guidance exists for control of spontaneous bleeding episodes and of haemostasis in general surgery, information for management of haemostasis in patients with various malignancies is sparse. To date, no clinical guidelines exist for management of complex bleeding problems, diagnosis, therapy and follow-up of malignancies in haemophilia. Furthermore, it remains unclear whether or not morbidity and mortality outcomes associated with malignancies are affected by haemophilia or by its treatment. Through presentation of five malignancies - prostate cancer, colorectal cancer, acute leukaemia, bladder cancer and hepatocellular carcinoma - important issues are highlighted, such as risk from bleeding as a symptom of malignancy; risks from invasive screenings and how these should be handled in haemophilic individuals; the implications of chemotherapy and treatment schedules, bone marrow suppression, radiotherapy, or surgery; and the likelihood of an interaction between treatment for haemophilia and malignancy outcomes. Ultimately, the aim is to establish consensus guidelines to direct and harmonize future treatment policy for malignant disease in the haemophilic population.
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PMID:Malignant disease in the haemophilic population: moving towards a management consensus? 2263 Jan 61


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