Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The author presents a case of metastatic hepatoma diagnosed at autopsy. The patient's liver had been nearly entirely replaced, and there were diffuse microscopic pulmonary metastases. Chest x-ray was normal at the time of gallium imaging for fever of unknown origin. Gallium imaging revealed a normal-appearing liver and mild, diffuse, bilateral increased uptake in the lungs. A CT scan 3 weeks before autopsy showed relatively minimal abnormality of the liver with a few areas of inhomogeneity and mild enhancement with contrast. Ultrasound-guided aspiration and liver biopsy were negative for tumor or infection. No case report or description of microscopic lung metastases from hepatoma seen with gallium was discovered in a recent literature search.
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PMID:Visualization of microscopic metastatic hepatoma to lung on gallium scintigraphy. 131 20

The laparoscopic and pathological diagnoses of 43 patients who underwent abdominal laparoscopy for various indications are presented. Major indications for the laparoscopy included hepatomegaly in 32 patients, ascites in 28, and pyrexia of unknown origin (PUO) in 18 patients. A combination of two or more of these indications was a more common feature. The most frequently encountered laparoscopic diagnoses were tuberculosis and chronic liver disease (16 patients each), followed by cancer (9 patients). However, on pathological examination of peritoneal or liver biopsy tissue and on follow-up, tuberculosis was confirmed in 12 patients, chronic liver disease in 14 patients and hepatocellular carcinoma in 11 patients. No complications were encountered during the laparoscopy. Our findings indicate that abdominal laparoscopy is a safe, quick and inexpensive diagnostic tool, particularly when appropriate and adequate tissue is taken for pathological examination. In such instances, laparoscopy would save an unnecessary laparotomy, especially where tuberculosis and cancer are considered in the differential diagnosis.
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PMID:Tuberculous peritonitis: the value of laparoscopy. 166 76

Among 130 patients with fever of unknown origin (FUO) studied from 1981 to 1985, 34 were diagnosed as having hepatobiliary disorders: amoebic liver abscess (11), pyogenic liver abscess (4), hepatic hydatid cysts (2), hepatic fascioliasis (2), tuberculous hepatic granulomas (1), chronic calcular cholecystitis with recurrent cholangitis (2), chronic active hepatitis (2), hepatocellular carcinoma (3), lymphoma involving the liver (4) and hepatic metastasis in (3) cases. Hepatobiliary disorders were the cause in 27% of FUO seen during 4 years.
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PMID:Hepatobiliary disorders presenting as fever of unknown origin in Cairo, Egypt: the role of diagnostic ultrasonography. 329 87

Diagnostic laparoscopy has still important implications in the differential diagnosis of numerous diseases despite the impact of non invasive imaging procedures. One of the most important indication, besides chronic liver diseases, is staging of malignancies. Laparoscopy improves considerably the predictability whether a distal carcinoma of the esophagus, or a stomach cancer or a pancreatic carcinoma can be resected. Laparoscopy is unbeaten in diagnosing peritoneal metastases. Thus, laparoscopy prevents unnecessary explorative laparotomies. Regarding tumor staging, a comparison is mandatory between minilaparoscopy, conventional laparoscopy in analgosedation performed by the gastroenterologist and laparoscopy in intubation anesthesia performed by the surgeon immediately before planned laparotomy. The significance of minilaparoscopy especially regarding chronic liver diseases and correct diagnosis of liver cirrhosis and hepatocellular carcinoma in cirrhosis will certainly increase. Laparoscopy remains to be an important diagnostic tool in diseases of unknown causes, i.e. fever of unknown origin. Laparoscopic sonography is the most sensitive method to detect small liver tumors, such as metastases or multilocular hepatocellular carcinoma.
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PMID:[Laparoscopy in differential internal medicine diagnosis]. 1121 28

Fever of unknown origin (FUO) is defined as fever of more than 38.3 degrees C, the cause of which remains elusive after 1 week of intensive investigation. Most cases of FUO are restricted to infections, malignancies, and inflammatory diseases. FUO was previously reported as the presenting symptom of a few solid tumors such as lymphoma, renal cell carcinoma, and hepatocellular carcinoma. Colon carcinoma manifesting as FUO has been rarely reported. We describe three female patients who presented with classical FUO and microcytic anemia. As a control, we retrospectively evaluated 28 matched patients with carcinoma of colon and no fever. The evaluation included review of patient files, clinical and laboratory data, and pathologic specimens. In the three patients (mean age, 58 years) who presented with FUO and had left-sided colon carcinoma and microcytic anemia, pathologic evaluation of the tumor tissues demonstrated a severe organized inflammatory process forming abscesses in the pericolic fat. The 28 control matched patients showed no such histopathologic changes. In patients presenting with FUO, especially those who present with microcytic anemia, even with no bowel disturbances or elevated carcinoembryonic antigen levels, diagnostic workup should include a search for occult colorectal carcinoma. In our three cases, it appears that microabscesses in the pericolic fat are the cause of fever.
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PMID:Carcinoma of colon presenting as fever of unknown origin. 1595 76

Hepatic cat scratch disease is rarely reported in liver transplant recipients and has never been reported with discrete liver lesions in the graft. A 52-year-old woman was transplanted for hepatitis C cirrhosis and hepatocellular carcinoma. Her posttransplant course was uneventful. She presented 2.7 years after transplantation with fever of unknown origin and went on to develop multiple and diffuse discrete liver lesions. Despite an extensive work-up including percutaneous and laparoscopic biopsies, a subsegmental resection that included one of these masses was required to make the diagnosis of Bartonella henselae infection. Serologic tests were equivocal. Histology was consistent with cat scratch disease of the liver, and polymerase chain reaction (PCR) testing of the resected tissue confirmed the diagnosis. Response to doxycycline was rapid. Fevers resolved within 7 days. Repeat abdominal CT scan showed reduction of the liver masses. Cat scratch disease should be considered in postliver transplant patients presenting with fever and liver lesions, especially if close contact with cats has occurred. Diagnosis by PCR testing of involved tissue is preferred when serologies are equivocal due to immunosuppression.
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PMID:Cat scratch disease causing hepatic masses after liver transplant. 1724 93

We present the case of a rare cause of fever of unknown origin (FUO). FUO is challenging for patients as well as for physicians as there are more than 200 differential diagnoses of FUO (1,2). Pointing out a diagnosis often requires numerous noninvasive and invasive procedures that sometimes even fail to explain the fever. Our patient was admitted twice to our hospital due to remitting fever rising up to 40 degrees C without any subjective discomfort. At the first presentation no clinical focus could be identified. This included the examination of multiple blood and urine cultures, serology, autoimmune serology, transesophageal echocardiography, CT-scan of the lung and the abdomen, and bone scintigraphy. Elevated C-reactive protein (268 mg/l) decreased spontaneously and fever disappeared after 4 weeks. However, the patient was re-admitted 4 months later with identical symptoms. Multiple blood and urine cultures, serology, bone marrow examination, CT-scan of the lung and the abdomen, esophago-gastro-duodenoscopy and colonoscopy still showed no pathological findings. MRI-scan of the abdomen identified a liver tumor of 3.3 cm in diameter in segment 6 without typical signs of an adenoma, focal nodular hyperplasia or hepatocellular carcinoma. Biopsy of the suspect liver lesion revealed an inflammatory myofibroblastic tumor (inflammatory pseudotumor). After surgical resection of the tumor elevated inflammation markers as C-reactive protein normalized and fever disappeared. One year after surgery no more episodes of fever re-occurred. An inflammatory myofibroblastic tumor of the liver can be a rare cause of fever of unknown origin. MRI-scan can be an additional imaging tool to identify previously not recognized liver tumors.
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PMID:A rare case of fever of unknown origin: inflammatory myofibroblastic tumor of the liver. Case report and review of the literature. 2340 91

The incidence of hematologic malignancies and their extranodal manifestations is continuously increasing. Previously unsuspected hepatic involvement in hematologic malignancies such as Hodgkin disease and non-Hodgkin lymphoma, posttransplant lymphoproliferative disorder, myeloid sarcoma (chloroma), multiple myeloma, Castleman disease, and lymphohistiocytosis may be seen by radiologists. Although the imaging features of more common hepatic diseases such as hepatocellular carcinoma, metastases, and infection may overlap with those of hepatic hematologic malignancies, combining the imaging features with clinical manifestations and laboratory findings can facilitate correct diagnosis. Clinical features that suggest a hematologic neoplasm as the cause of liver lesions include a young patient (<40 years of age), no known history of cancer, abnormal bone marrow biopsy results, fever of unknown origin, and night sweats. Imaging features that suggest hematologic malignancy include hepatosplenomegaly or splenic lesions, vascular encasement by a tumor without occlusion or thrombosis, an infiltrating mass at the hepatic hilum with no biliary obstruction, and widespread adenopathy above and below the diaphragm. Familiarity with the imaging features of hepatic hematologic malignancies permits correct provisional diagnosis and may influence therapeutic management. For example, when biopsy is performed, core biopsy may be needed in addition to fine-needle aspiration so that the tissue architecture of the neoplasm can be discerned. The predominant treatment of hematologic malignancies is chemotherapy or radiation therapy rather than surgery. Online supplemental material is available for this article.
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PMID:Hematologic malignancies of the liver: spectrum of disease. 2656 43