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How to differentiate macro-regenerative nodules from hepato-carcinoma?
October 13, 2008BA, the congenital absence or destruction of intra- or extra-hepatic biliary system, affects about 5 - 10/100 000 live births. End stage liver cirrhosis developed in some BA patients later in life. As a result of liver cirrhosis, regenerative nodules may develop in cirrhotic liver including a specific type termed MRN. The clinical significance and pathological features of MRN have been discussed in some articles. However, the image features of MRN and how to differentiate them from HCC have yet to be elucidated.
A research article to be published on July 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Yu-Fan Cheng from Chang-Gung memorial hospital- Kaohsiung medical center found that MRN developed in about 5% BA patients and there was no malignant change within them based on the histopathological finding of 144 extracted livers. The authors also reviewed pre-transplantation image surveys including CT and MRI.
They found that the MRN may have typical and atypical images features in CT/MRI. Typical MRN which are found in about 5/8 are hyperdense on pre-contrast CT and hypointense on T2WI MRI as compared with surrounding liver parenchyma. They had intra-tumoral tubular vascular bundles and showed no enhancement. These features can be used to differentiate from HCC. Atypical MRN which are found in 3/8 showed arterial enhancement and may be interpreted as signs of malignant change. Liver biopsy may aid in making a decision before liver transplantation (LT).
LT should not be withheld in BA patients based solely on images because benign lesions may also have images which look like HCC. The combined use of alfa-feto-protein , images and sometimes liver biopsy are still helpful in pre-transplant survey. The result of this article implies that liver biopsy can be avoided if supported by the typical images of MRN and repeated biopsy is not necessary if the AFP value is incongruent with radiographic findings.
World Journal of Gastroenterology
LT should not be withheld in BA patients based solely on images because benign lesions may also have images which look like HCC. The combined use of alfa-feto-protein , images and sometimes liver biopsy are still helpful in pre-transplant survey. The result of this article implies that liver biopsy can be avoided if supported by the typical images of MRN and repeated biopsy is not necessary if the AFP value is incongruent with radiographic findings.
World Journal of Gastroenterology
Liver Cirrhosis Current Events and Liver Cirrhosis News RSSMayo Clinic's new imaging technology accurately identifies a broad spectrum of liver disease
A new study shows that an imaging technology developed by Mayo Clinic researchers can identify liver fibrosis with high accuracy and help eliminate the need for liver biopsies. Liver fibrosis is a common condition that can lead to incurable cirrhosis if not treated in time.
If the diabetes has a direct carcinogenetic effect?
The association of DM2 with solid tumors, and particularly with HCC, has been long suspected and several studies have reported increased mortality rates for neoplastic diseases in patients with DM2.
Toxic Bile Damages the Liver
Researchers at the Heidelberg University Hospital have discovered a new genetic disease that can lead to severe liver damage. Because a protective component of the bile is missing, the liver cells are exposed to the toxic components of the bile, resulting in cirrhosis of liver, a transformation of liver cells into connective tissue with a gradual loss of liver function.
The risk factors of idiopathic pulmonary fibrosis in HCV patients
Hepatitis C virus (HCV) is one of the more common causes of chronic liver disease in world with a variety of extrahepatic complications such as essential mixed cryoglobulinemia, membranoproliferative glomerulonep hritis, autoimmune thyroiditis, sialadenitis, and cardiomyopathy.
An effective strategy for inhibition of cirrhosis
In China, the incidence of liver cirrhosis is still high, although new therapeutic approaches have recently been proposed, there is no established therapy for liver fibrosis, and Authors investigated the prevention effects of Chinese Medicine Qianggan-Rongxian Soup on liver fibrosis induced by DMN in rat.
How to select anti-hepatitis B virus agents for drug-resistance patients?
HBV infection may lead to acute liver disease, chronic active hepatitis, liver cirrhosis, and hepatocellular carcinoma. Over 350 million people worldwide are estimated to be infected chronically by HBV and are therefore at risk of liver failure, cirrhosis, or hepatocellular carcinoma.
New lights on the pathogenic mechanisms of liver cirrhosis with ascites
The pathogenic mechanisms implicated in the failure of intestinal barrier in cirrhosis have not been fully elucidated as yet and remains to be investigated.
Noninvasive test accurately identifies advanced liver disease without biopsy
Non-invasively measuring liver stiffness with transient elastography accurately diagnoses patients with late-stage liver disease, reports a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.
To protect against liver disease, body puts cells 'under arrest'
A stable form of cell-cycle arrest known to offer potent protection against cancer also limits liver fibrosis, a condition characterized by an excess of fibrous tissue, according to a new report in the August 22nd Cell, a Cell Press publication.
High circulating D-dimers are associated with presence of ascites
The liver is the production site of most of the proteins which favour and inhibit the process of coagulation and fibrinolysis.
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