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Hepatic Mass (hepatic + mass)
Selected AbstractsRacial differences in effectiveness of ,-fetoprotein for diagnosis of hepatocellular carcinoma in hepatitis C virus cirrhosisHEPATOLOGY, Issue 2 2002Mindie H. Nguyen ,-Fetoprotein (AFP) is frequently used as a diagnostic marker for hepatocellular carcinoma (HCC). Most available data concerning AFP come from studies of patients with chronic hepatitis B or other chronic liver diseases of mixed etiologies. Limited data concerning the diagnostic value of AFP for hepatitis C virus (HCV)-related HCC have to date come only from Asian and European studies, and results are conflicting. There may be significant differences in AFP levels depending on racial backgrounds and etiologies of primary liver disease. We conducted a multicenter, retrospective, case-control study of 163 HCC patients with HCV infection and 149 control patients with HCV-related cirrhosis. The positive likelihood ratios for AFP at 0 to 20, 21 to 50, 51 to 100, and 101 to 200 ng/mL were 0.46, 1.31, 1.15, and 6.90, respectively. No controls had AFP greater than 200 ng/mL. The sensitivity of AFP for the diagnosis of HCC in African Americans with HCV infection was lower than that of patients of all other ethnic groups combined (57.1% vs. 81.6% for AFP > 10 ng/mL, P = .02, and 42.9% vs. 66.0% for AFP > 20 ng/mL, P = .05). The area under the receiver operating characteristics curve was 0.81 for non-African Americans but only 0.56 for African Americans. In conclusion, AFP greater than 200 ng/mL can be used to confirm HCC in patients with HCV-related cirrhosis and a hepatic mass. However, AFP is insensitive for the diagnosis of HCC in African Americans. [source] Severe hypercalcemia and solitary hepatic mass as initial manifestation of primary hepatic lymphomaLIVER INTERNATIONAL, Issue 2 2001Daniel N. Nan [source] Unique vascular tumor primary arising in the liver and exhibiting histopathological features consistent with so-called polymorphous hemangioendotheliomaPATHOLOGY INTERNATIONAL, Issue 12 2009Lorenzo Cobianchi Reported herein is an unusual vascular tumor primary arising in the liver and exhibiting unique histopathological features. A 47-year-old woman underwent left hepatectomy because of a large hepatic mass. On histology the tumor had a composite pattern, consisting of angiomatous, retiform and solid areas, formed by oval to cuboidal to spindle cells, that expressed only endothelial markers (CD31 and factor VIII-related antigen). These findings led to the diagnosis of a low-grade vascular neoplasm with morphological features consistent with so-called polymorphous hemangioendothelioma. The tumor was completely resected. At 24 month follow up the patient was alive, without evidence of disease. Polymorphous hemangioendothelioma is a rare vascular neoplasm, with borderline malignant potential, which usually occurs in lymph nodes and, rarely, at extranodal sites. Its classification as an entity has been questioned recently. The unusual morphological features of the present case, which do not fit neatly with any other recognized hemangioendothelioma subtype, indicate that the family of vascular tumors is broader than currently accepted. In addition the present case widens the spectrum of primary vascular tumors arising in the liver. [source] Surgical removal of a localised vascular hepatic hamartoma in a dogAUSTRALIAN VETERINARY JOURNAL, Issue 9 2009M Gualtieri A 2-year-old male Labrador Retriever was presented for sudden abdominal distension. Abdominal ultrasonography revealed abundant abdominal fluid and a hepatic mass, which was removed by total lobectomy. Histologic evaluation of the mass supported a vascular hepatic hamartoma. Vascular hamartomas are rare malformations in animals and only two cases have been reported in the dog. This is the first recorded case of a canine vascular hepatic hamartoma treated surgically and having a successful long-term outcome. [source] Detection and differential diagnosis of hepatic masses using pulse inversion harmonic imaging during the liver-specific late phase of contrast enhancement with levovistJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2002Cem Yücel MD Abstract Purpose The purpose of this study was to investigate whether late-phase pulse inversion harmonic imaging (PIHI) increases conspicuity in hepatic masses, helps to differentiate benign from malignant lesions, and demonstrates a greater number of and smaller metastatic lesions than do conventional (fundamental) sonography and helical CT. Methods Thirty patients (17 women and 13 men; age range, 35,77 years; mean age, 54 years) with known or suspected liver masses were evaluated using both fundamental sonography and contrast-enhanced PIHI during the liver-specific late phase of Levovist. The patients also underwent contrast-enhanced triphasic helical CT examinations within 1 week after sonography. In 4 of the patients, gadolinium-enhanced MRI was also performed as a part of their clinical work-up. Results The increase in the lesions' conspicuity on PIHI compared with fundamental sonography was significantly greater in malignant lesions than in benign lesions (p< 0.001). An echogenic rim was observed on PIHI in 8 (53%) of 15 malignant lesions. The mean number of metastatic lesions visualized on PIHI (5.5 ± 5.3) was significantly higher than the mean number visualized on fundamental sonography (2.5 ± 2.1, p < 0.05). Although lesions as small as 3 mm were observed on PIHI, the mean sizes of the smallest lesions demonstrated using fundamental sonography, PIHI, and helical CT were not significantly different. Conclusions Late-phase PIHI is a useful technique for characterizing hepatic lesions and demonstrating both a greater number of and smaller metastases. It may help to differentiate benign from malignant liver masses and may obviate unnecessary and expensive further imaging. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:203,212, 2002; Published online in Wiley InterScience (www.interscience. wiley.com). DOI: 10.1002/jcu.10053 [source] Resovist enhanced MR imaging of the liver: Does quantitative assessment help in focal lesion classification and characterization?JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2009Lucia Santoro MD Abstract Purpose: To improve characterization of focal liver lesions by a prospective quantitative analysis of percentage signal intensity change, in dynamic and late phases after slow (0.5 mL/s) Resovist administration. Materials and Methods: Seventy-three patients were submitted on clinical indication to MR examination with Resovist. Signal intensity of 92 detected focal lesions (5,80 mm) were measured with regions of interest and normalized to paravertebral muscle in arterial, portal, equilibrium and T1/T2 late phases, by two observers in conference. Five values of percentage variations per patient were obtained and statistically evaluated. Results: The enhancement obtained on dynamic study is more suitable in hemangiomas and focal nodular hyperplasias than in adenomas and hepatocellular carcinomas. To discriminate benign versus malignant lesions on late-phase-T2-weighted images, a cutoff = ,26%, allowed sensitivity and specificity values of 97.4% and 97.7%, respectively. Area under the receiver operating characteristic (ROC) curve was 0.99. To differentiate hemangioma versus all other focal liver lesions, on late-phase-T1-weighted images, a cutoff = +40% permitted sensitivity and specificity values of 90.5% and 98.0%, respectively. Area under the ROC curve was 0.98. Conclusion: Late phase quantitative evaluation after slow Resovist administration, allows to differentiate malignant from benign hepatic masses and hemangiomas from all the others focal liver lesions, on T2-/T1-weighted acquisitions, respectively. J. Magn. Reson. Imaging 2009;30:1012,1020. © 2009 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||