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Query: UMLS:C0023890 (
cirrhosis
)
42,195
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Thirty-nine patients with focal defects on the technetium liver scan were rescanned using 111-In chloride. Of 20 patients with hepatic malignancy, 11 had positive indium scans. None of the 19 with focal cirrhotic fibrosis had a positive indium scan although 5 of these had
primary tumor
. Thus, a positive indium scan suggests that the defect is malignant. A negative indium scan is less helpful, failling to distinguish between neoplasm and focal
cirrhosis
. Positive uptake in an extrahepatic primary neoplasm and negative uptake in the liver suggest that the hepatic lesion is not neoplastic.
...
PMID:Experience with 111-In-chloride scanning in patients with focal defects on 99-mTc-sulfur colloid liver scans. 16 25
Although early survival following transplantation for primary hepatic cancer is excellent, previously reported high recurrence rates have generally discouraged liver replacement for this indication. Since the inception of the Boston Center for Liver Transplantation (BCLT) in 1983, 33 of 383 (8.6%) liver allograft recipients have undergone orthotopic transplantation as definitive treatment for otherwise unresectable cancer. Diagnoses included hepatocellular carcinoma (HCCA) in 24 patients (73%), and cholangiocarcinoma (CHCA) in 9 patients (27%). Actuarial survival rates for patients with hepatocellular carcinoma were 71%, 56%, and 42% at 1, 2, and 3 years, respectively. The actuarial survival rates for patients with cholangiocarcinoma were 89% at 6 months, and 56% at 1, 2, and 3 years. Of the nine patients with cholangiocarcinoma, 56% (5/9) developed recurrent disease. Although this recurrence rate is disheartening, because of the lack of other morbidity, long-term survival in these patients is comparable to patients with HCCA. In contrast, recurrent hepatocellular carcinoma developed in 25% of recipients (5/20) who survived longer than 3 months posttransplantation. Other causes of death in patients with hepatocellular carcinoma included perioperative complications, 16.6% (4/24); sepsis, 8.3% (2/24); coronary artery disease, 4.2% (1/24); and lymphoma, 4.2% (1/24). Favorable prognostic factors included:
primary tumor
less than 3 cm in size and absence of associated
cirrhosis
. These results emphasize that orthotopic liver transplantation can provide a long-term cure for approximately 50% of patients whose primary hepatic malignancy is unresectable by conventional procedures.
...
PMID:Liver transplantation for primary hepatic cancer. 131 Aug 23
We report the diagnostic, prognostic and therapeutic features of non-Hodgkin's lymphoma in eight patients in whom the disease was seen as a
primary tumor
of the liver. This series illustrates the variety of situations in which lymphoma might be diagnosed: (a) abdominal pain and hepatomegaly (three cases), (b) incidental finding at evaluation of a patient with
cirrhosis
(two cases), (c) secondary neoplasm after treatment for Hodgkin's disease (one case) and (d) complication of AIDS (two cases). In most cases, clinical and/or radiological features were nonspecific. However, the combination of the following features must be considered as suggestive: occurrence of an apparently primary hepatic tumor in an immunocompromised patient, absence of the usual serum tumor markers and increased serum lactic dehydrogenase activity. The final diagnosis was based on histological examination of specimens obtained by ultrasonically guided liver biopsies or at surgery. All cases belonged to unfavorable histological subtypes. Immunohistochemical findings on paraffin-embedded sections demonstrated the B-lymphocyte lineage of the seven tumors available for study. In the three patients without coexisting disease, complete remission was obtained by surgery alone or combined with chemotherapy. In the two patients with coexisting
cirrhosis
, outcome was rapidly unfavorable, with death occurring less than 3 mo after diagnosis. Among the three immunocompromised patients, two experienced a rapid unfavorable outcome, and the remaining one was in complete remission after surgery and chemotherapy. In conclusion, primary non-Hodgkin's lymphoma of the liver arising in patients without coexisting disease has a slow progression and might be successfully treated by surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Non-Hodgkin's lymphoma presenting as a primary tumor of the liver: presentation, diagnosis and outcome in eight patients. 202 91
Malignant ascites is often refractory to therapy and rapidly deteriorating the nutritional and physical state of the cancer patient. Nevertheless, ascites does not always implicate preterminal state of the cancer process (e.g. ovarian carcinoma). A short review is made of the pathophysiology of ascites in
cirrhosis
and in malignancy, and different modes of treatment are discussed. The results of medical therapy of malignant ascites (salt and water restriction, diuretics, intraperitoneal cytostatics or radiocolloids) are not convincing. The immunotherapy with OK-432, as worked out by Katano (16-46) has to prove its value. The best and most hopeful results in cases of massive previously resistant ascites, are obtained with a peritoneojugular shunt, improving immediately the nutritional status and life condition, providing excellent palliation. The superiority of the Denver shunt versus the Le Veen shunt has been assessed recently, especially for malignant ascites. Some technical and perioperative details merit more attention, to limit the high risk ratio. Control of the intrathoracic position of the catheter tip, the maintenance of the bloodflow in the jugular vein, the intramuscular tunnelisation of the peritoneal catheter, the discard of 3 or 5 liters ascitic fluid and the substitution of part of it by physiological fluid, perioperative prophylactic antibiotics and heparinisation, flow-rate control in the postoperative period by changing patients position, respiratory exercises, daily flushing, all those measures limit the risk of fibrinolysis (DIC), shunt occlusion, fluid overload and infection. The fear of metastasis by shunt is unfounded, since the survival of the
primary tumor
is mostly too short (41). The postoperative follow up in an intensive care unit is necessary during 24-72 hours.
...
PMID:[The Denver shunt in malignant ascites]. 258 Apr 8
Accurate detection of intrahepatic metastases, or daughter nodules, of primary hepatocellular carcinoma is of crucial importance. Due to the introduction of infusion hepatic angiography, computed tomography (CT) after Lipiodol (iodized oil) infusion, and intraoperative ultrasound (US), tumors less than 10 mm in diameter are now frequently found. We compared the diagnostic accuracy of these three modalities in the detection of nodules in 45 patients who had hepatocellular carcinoma (confirmed by biopsy). CT with Lipiodol was superior to hepatic angiography in demonstrating nodules when they were overlapped by the
primary tumor
or very small in size. Intraoperative US demonstrated nodules in four avascular or hypovascular hepatocellular carcinomas, which both hepatic angiography and CT failed to demonstrate. In cases associated with severe
liver cirrhosis
, differentiation of small nodules from regenerating cirrhotic nodules was sometimes difficult with intraoperative US. The combined use of these three modalities is indispensable for the accurate detection of small nodules of metastatic hepatocellular carcinoma.
...
PMID:Metastatic nodules of hepatocellular carcinoma: detection with angiography, CT, and US. 281 41
The morphological features of ninety-eight autopsy cases of hepatocellular carcinoma (HCC) were analyzed in relation to pulmonary metastasis. Extrahepatic hematogenous metastasis was observed in 64% and lung was most frequently involved (62%). A close relationship was observed between intrahepatic vascular invasion and extrahepatic hematogenous metastasis to lungs. Portal vein-invasion was found in 80% of cases and significant correlations were recognized between the rates of portal vein-invasion and hepatic vein-invasion, and between the rates of portal vein-invasion and pulmonary metastasis. There was a close correlation among the macroscopic growth-pattern, incidence of vascular invasion, and pulmonary metastasis, and their degrees. Namely, the expansive type HCC showed significantly lower rates of vascular invasion and pulmonary metastasis than the infiltrative or mixed type HCC. These rates were particularly low in the expansive type, single nodular subtype HCC with size of a
primary tumor
less than 10 cm. Significantly low rates of pulmonary metastasis and portal vein-invasion were also noted in well-differentiated carcinoma (Grade I or II). The existence of
cirrhosis
or fibrosis of liver in cases with HCC was not definitely related to the occurrence of pulmonary metastasis. It was originally clarified that invasion to the portal vein and the size of HCC played a main role in pulmonary metastasis.
...
PMID:Analysis of morphological factors of hepatocellular carcinoma in 98 autopsy cases with respect to pulmonary metastasis. 282 65
c-Hc-4 has been established and maintained for more than seven years. The hepatocellular carcinoma originated in 45-year old man with
liver cirrhosis
. The cell grew in vitro forming a sheet of monolayered cells and firmly attaching to the inner surface of cultured flasks. Morphologically they showed epithelial-like pattern. The doubling time was about 20 hours. Their modal chromosome number was 58. Serial heterologous transplantation in nude mice was successful. The histological finding was almost the same patterns as those in the
primary tumor
. The cultured cells produced alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA).
...
PMID:[Establishment of the human hepatocellular carcinoma cell line and its characteristics]. 285 42
Three patients with symptoms related to metastases from hepatocellular carcinoma are described. The diagnosis of the
primary tumor
was made at autopsy in two cases and by biopsy in one. The skeletal lesions had a lytic, expansile, and hypervascular appearance. This hypervascularity may lead to bleeding either spontaneously or following biopsy. Hepatocellular carcinoma should be included in the differential diagnosis of osteolytic, expansile, hypervascular metastases, especially when such lesions are encountered in patients with
liver cirrhosis
.
...
PMID:Hepatocellular carcinoma with skeletal metastasis. 298 74
Primary hepatocellular carcinoma metastasizing to abdominal lymph nodes and to the left lung was observed in a 16-year-old male patient. No clinically apparent chronic liver disease preceded the carcinoma and no signs of
cirrhosis
were detectable in the nonneoplastic liver. Hepatitis B surface antigen, hepatitis B e antigen and antibody to hepatitis B core antigen were found to be positive in the serum. By immunohistochemistry (peroxidase-antiperoxidase technique) hepatitis B surface antigen could be demonstrated in the nontumorous liver parenchyma, but not in the primary hepatocellular carcinoma itself. Serum alpha-fetoprotein was only moderately elevated (75 ng/ml), but immunohistochemically primary hepatocellular carcinoma revealed a considerable number of alpha-fetoprotein-containing cells, whereas nontumorous parenchyma did not. Carcinoembryonic antigen could be demonstrated immunohistochemically in some tumor cells of a lymph node metastasis, but not in the
primary tumor
or in the nontumorous liver parenchyma. We propose that primary hepatocellular carcinoma developed in this case in a symptomless hepatitis B virus carrier without preceding
cirrhosis
, an we exclude a simultaneous acute hepatitis B.
...
PMID:Primary hepatocellular carcinoma with hepatitis B virus infection in a 16-year-old noncirrhotic patient. 618 92
Our personal experience with 172 patients, the results from the European Liver Transplant Registry and a review of the recent literature are summarized and discussed to define present indications for liver transplantation in hepatobiliary malignancy. The following conditions should be considered contraindications: advanced primary liver tumors with any extrahepatic spread, cholangiocellular carcinoma, hemangiosarcoma and liver metastases from nonendocrine
primary tumor
. Currently, "favorable" indications include uncommon tumors such as fibrolamellar carcinoma, epithelioid hemangioendothelioma, hepatoblastoma and metastases from endocrine tumors. Further indications may be nonresectable hepatocellular and proximal bile duct carcinoma in tumor stage II. Borderline indications are hepatocellular and proximal bile duct carcinoma in tumor stage III. In advanced tumors confined to the liver, transplantation should be restricted to multimodality treatment protocols. Although there are strong arguments for transplantation in early resectable hepatocellular carcinoma with underlying
cirrhosis
, it remains an open issue requiring further investigation in a controlled study using the same tumor classification. With regard to limited resources of donor organs, split-liver transplantation permits transplantation in tumor patients without neglecting those with benign diseases.
...
PMID:Indications for liver transplantation in hepatobiliary malignancy. 800 78
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