Solitary necrotic nodule of the liver: different pathological findings express a different histogenesis (original) (raw)
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Solitary necrotic nodule of the liver: imaging and correlation with pathologic features
Abdominal Imaging, 2003
We describe two cases of solitary necrotic nodule of the liver, an uncommon nonmalignant lesion that can mimic a metastasis. The nodule appeared hypoechoic, or targetlike, on sonography, hypodense without contrast enhancement on computed tomography, and hypointense on magnetic resonance imaging, including diffusion-weighted images. These features, peculiar when considered together, are explained by the coagulative type of necrosis.
Journal of Surgical Oncology, 2000
In our experience, we document 2 cases of a rare and non-tumoral lesion of the liver misinterpreted as necrotic tumor: necrotic solitary nodule. In the first clinical case, ultrasound (US) showed a polylobated lesion (35 × 35 × 38 mm) at segment 8. Color-doppler identified a compression of celiac axis (Dunbar syndrome). Arteriography revealed a subtotal stenosis of celiac tripod soon after the emergence of the left gastric artery. FNAB-CT showed a highly cellulated tissue with a necrotic core surrounded by a fibersclerotic tissue. The patient underwent surgery: cholecystectomy and correction of Dunbar syndrome. US follow-up showed a progressive reduction in diameter of the lesion (24 × 25 × 25 mm at 24 months), suggesting in this case the role of ischemic injury in the pathogenesis of the lesion.
Nodule in Liver: Investigations, Differential Diagnosis and Follow-up
Journal of clinical and experimental hepatology, 2014
Conventional ultrasonogram of the abdomen being noninvasive, inexpensive and ubiquitously available is the first imaging modality that raises suspicion of HCC in a patient with chronic liver disease with or without cirrhosis. The lesions in liver particularly nodule are being recognized with increased frequency with the wide spread use of ultrasonogram as the initial investigation and computerized tomography and magnetic resonance imaging subsequently. Any nodule in a cirrhotic liver should be considered as hepatocellular carcinoma until otherwise proved. This approach certainly is helpful in diagnosing HCC at its earliest possible stage to offer meaningful curative measures be it transplant, resection or ablative therapy. After a nodule is detected on ultrasonogram the next imaging modality can be a contrast enhanced study (dynamic CT scan or an MRI) to see if are present or not. Two vital clues for diagnosis of HCC by contrast enhanced imaging are presence of arterial hypervascula...
Cytology and cytogenesis of neoplastic (hyperplastic) hepatic nodules
Cancer research, 1976
Cytochemical and electron microscopic investigations of neoplastic nodules induced in the rat liver by nitrosomorpholine or thioacetamide show that most neoplastic nodules are comprised of a rather heterogeneous cell population. At least four different types of altered hepatocytes can be distinguished: (a) "clear" glycogen storage cells with a dislocation and relative reduction of the granular endoplasmic reticulum; (b) "acidophilic" glycogen storage cells with a hypertrophy of the agranular endoplasmic reticulum; (c) fat-storing cells; and (d) basophilic cells poor in glycogen and rich in ribosomes. In addition, there are diverse intermediate cell types. The cytochemically demonstrable activity of glucose-6-phosphatase is reduced in most neoplastic nodules, but it may also be normal or even increased. The clear and the acidophilic cells precede the development of the neoplastic nodules by weeks and months. They usually form foci which are taken to be preneoplast...
Cytomorphological Patterns of Nodular Lesions of Liver
2012
Background and Objectives: Nodular lesions of liver are usually neoplastic (primary or metastatic), although inflammatory lesions can occur. The objectives of this paper were to study the cytomorphological changes in various nodular lesions of liver and to correlate the cytomorphological findings with biochemical parameters especially serum alpha-fetoprotein. Materials & Methods: A cross-sectional study consisting of 40 patients with nodular liver lesions was carried out at Regional Institute of Medical Sciences (RIMS) during the period from August 2008 to July 2010 (2 years). A detailed clinical history and relevant data were collected. Fine needle aspiration cytology (FNAC) findings were correlated with clinical and biochemical parameters especially alpha-fetoprotein (AFP). Statistical analyses of the results were done and discussed. Results: Out of these 40 patients, 28 (70%) were male and 12 (30%) were female with a male female ratio of 2.3:1. Age of the patients ranged from 13 years to 85 years with a mean age of 47.5 yr. Regarding the FNAC diagnosis, 18 cases (45%) were non-neoplastic and 22 cases (55%) were neoplastic. Out of the total 22 malignant lesions, majorities were metastases with 14 cases (63.6%) and 8 cases (36.4%) were hepatocellular carcinoma (HCC). 75% of HCC patients (6 cases) had markedly elevated serum AFP level (> 500 ng/ml). The association of hepatic malignancy with serum alpha-fetoprotein level was found to be statistically significant. Conclusion: This study emphasized on unique cytomorphological patterns of distinctive liver lesions for the diagnosis by FNAC and importance of the interpretation of FNAC results along with serum alpha-fetoprotein level in the cases of malignancy.