Focal Nodular Hyperplasia (FNH)

In our study: statistically, the extent of agreement between dynamic contrast MRI and histopathological staging was almost perfect (κ =0.880) and highly significant (P = 0.001), which is higher compared to the study done by Gupta N. and his colleagues on 60 patients, that resulted in good agreement equals (κ =0.690) and

An abdominal ultrasound was performed on September 13, 2017 that indicated a small hemangioma in the left hepatic lobe (Ex. B20F).

The MD Anderson Liver Tumor biospecimen resource has been invaluable for a large number of studies or clinical development. The sixth and subsequent editions of the American Joint Committee on Cancer (AJCC) staging of hepatocellular cancer, which was developed by an international consortium led by Jean-Nicolas Vauthey, MD, Professor of Surgery at MD Anderson and co-leader on project 2 of the SPORE, was based upon pathologic review of resected specimens in the Liver Tumor Bank (Vauthey JN J Clin Oncol 2002 20:1527-36). In addition, investigators at MD Anderson examined tissues in the Liver Tumor Bank to elucidate the prognostic significance of the ribonucleoprotein Human Antigen R (HuR) showing that patients with high HuR tumor expression had

This is a 43-year-old male who came in ER with complain of weight loss, about 50 pounds in last 4 months, intermittent vomiting, abdominal pain. Patient has been admitted to hospital as an inpatient as his CT scan showed severe bowel perforation and peritonitis. Patient underwent for exploratory laparotomy followed by sigmoidectomy with colostomy. His previous CT scan (02/2016) revealed multiple liver lesions, largest measuring left hepatic lobe 4 x 5.5 cm and the right hepatic lobe as well as multiple periportal and peripancreatic adenopathy in the stomach and pancreas measuring , and periportal node and prominent epigastric notes. He had a CT-guided biopsy of the liver on 03/02/2016 which revealed carcinoma consistent with Stage IV squamous cell carcinoma of stomach and esophagus with metastasized to the liver. The patient has been on chemotherapy, recently completed 3rd cycle on chemotherapy.

FDG PET imaging is useful for preoperative diagnosis of pancreatic carcinoma in patients with suspected pancreatic cancer in whom CT fails to identify a discrete tumor mass or in whom FNAs are non diagnostic. FDG PET imaging is useful for M staging and restaging by detecting CT occult metastatic disease, allowing non curative resection to be avoided. FDG PET can differentiate post-therapy changes from recurrence and holds promise for monitoring neoadjuvant chemoradiation therapy.

Unlike other cancers the surgery is the only procedure used to try to cure liver cancer. (LaRusso-c) d. Quote to support sub-topic #4: Doctors may have images taken with an Angiogram, MRI scan, CT scan, or X-rays to help diagnose Liver cancer.

Furthermore, WBRT, positron-emission computed tomography (PET-CT) showed multiple suspicious lesions in both lungs as well as in spleen. In the liver solitary FDG avid lesion highly suspicious of metastatic foci was visible. Fig 2.

In the severe fatty liver, the typical appearance of hemangiomas is altered. The lesion may appear hyperechogenic, isoechogenic or hypoechogenic compared to the steatotic liver with or without a posterior acoustic enhancement at US examination. In non-contrast CT the lesion may be found hyperdense or isodense (2, 21). When a contrast material is used or when T2-weighted images are acquired the presence of hepatic steatosis does not affect the appearance of hemangiomas. A perilesional zone may be seen without fat infiltration (22,

The largest diameter of targeted lesion was measured with ultrasound, CT or MRI. We defined depth of the lesion as the amount of liver parenchyma, which was traversed to the targeted liver lesion. The lesion depth was measured with ultrasound before the procedure, for selected the proper length of the biopsy

After administration of contrast material, a discontinuous, nodular, peripheral enhancement develops in the arterial phase, which progresses to more centripetal fill-in in the portal venous phase and ends up in irregular fill-in and isoattenuating or hyperattenuating appearance in the delayed phase (6). The density of a cavernous hemangioma is the same of a vessel (1). Capillary hemangiomas, like other typical hepatic hemangiomas, appear mildly hypodense but sometimes they may become isodense on non-contrast CT images (7). The kinetics of enhancement is rapid and like to that of the aorta, i.e. an early, homogenous intense enhancement in the arterial phase is usually seen (8). The presence of hypodense focal nodular patches that correspond to sclerotic zones is the main CT feature of sclerosed hemangiomas

Thus a diameter of greater than 20 mm is regarded as aneurysm. The intrahepatic portal branch aneurysms are considered if they measure greater than 7 mm in normal and 8.5 mm in cirrhotics [1].

Initial liver biopsy is recommended for assessment of the inflammatory activity and the severity of fibrosis, which is useful for making therapeutic decision. The work-up shows that interface and zone 1 lobular hepatitis is the hallmark with the characteristic lymphoplasmacytic infiltrate, typically prominent portal and periportal (in case of bridging necrosis or cirrhosis) inflammation which generally spares the bile ducts, and acinar transformation of hepatocytes (rosettes formation). Plasma cells may not be dominant but prominent inflammatory cells only at the interface. The non-specificity of histological findings to autoimmune hepatitis should always be remembered, and the absence of plasma cells does not preclude the diagnosis. Meanwhile,

The progression from fibrosis to cirrhosis, the end-point of CLDs, is distinguished by a prolonged inflammatory and fibrogenic process that leads to an abnormal angioarchitecture distinctive for cirrhosis. Several mechanisms are responsible for the angiogenic switch during the pathogenesis of CLDs. First, CLDs are characterised by chronic inflammation. Increased intrahepatic vascular resistance is primarily caused by anatomical changes, such as fibrotic scar tissue compressing portal and central venules. In addition, the formation of fibrotic septa, as well as sinusoidal capillarisation, can result in an increased resistance to blood flow and oxygen delivery. This results in hypoxia and the transcription of hypoxia-sensitive pro-angiogenic

Liver cancer usually does not have any symptoms in its early stages and can be difficult to detect. Nevertheless, liver cancer can be detected by imaging tests. Some of the tests used to diagnose liver cancer are Ultrasound, Computed tomography (CT scan), Magnetic resonance imaging (MRI scan), Biopsy and Laparoscopy. Ultrasound uses high frequency sound waves to generate a picture of the body and is used to show any abnormal growths in the liver. The CT scan is an x-ray test that produces detailed images of the body. This test can be very useful in precisely identifying liver tumors. The MRI also creates detailed images, but uses radio waves and

Radiological diagnosis is to obtain liver imaging using ultrasonography, CT scanning, or MRI .When performed for suspected hepatocellular carcinoma due to a rising AFP, each test has a 70-85% chance of finding a solitary lesion; sensitivity is higher with multiple tumors.