Ultrasonically guided percutaneous fine-needle aspiration biopsy of hepatic focal lesions

Ultrasonically guided percutaneous fine-needle aspiration biopsies of the liver were performed on 215 patients with a clinical and sonographic suggestion of hepatic malignancy. Several aspirations at the suspected areas were made in each case. The aspirate cytology was positive for malignancy in 161 cases [hepatocellular carcinoma 98 cases, anaplastic carcinoma 12, angiosarcoma 9 and metastatic carcinoma 42]. There were no false positive results. 145 cases with malignancy were diagnosed on the initial aspirate and among the negative cases, 16 showed evidence of malignancy on repeated aspiration [false negative in 9.9 percent, dropped to zero level on re-aspiration]. Aspirate cytology in the non-malignant focal areas revealed: haemangioma in 9 cases, echogenic liver abscesses, focal fatty degeneration 15, regenerative nodules in 22 cases. The puncture and aspirate of these 215 cases did not reveal any immediate compactions. Multiple fine-needle aspirate cytology of hepatic focal areas under ultrasonic guidance are of great diagnostic value with high accuracy in detecting hepatic malignancy

Immunoglobulins in bilharzial patients with and without chronic hepatitis

The mean values of IgG and IgA were significantly higher in bilharzial patients than in the non-bilharzial ones. The mean IgG level in patients with S. mansoni was significantly higher than that in patients with negative stool, while the reverse was true as regards IgA. Among the bilharzial patients the mean values of IgG, IgM and IgA were significantly higher in CAH and CAH. bilharziasis than in patients with pure bilharziasis, CPH and CPH with bilharziasis. It might be concluded that the altered immune response produced by schistosomiasis, the frequent exposure to the hepatitis B virus and the bilharzial hepatitis lesions, all may pave the way for development of severe diseases, e.g. chronic active hepatitis and liver cirrhosis

Surgical evaluation of histology assessment of activity in cirrhosis: a suggested grading system

Histopathological assessment of activity in liver cirrhosis, is a very important parameter amongst others, in the determination of the clinical and surgical outcome of patients. The currently used Modified Child's classification, is a clinicolaboratory scoring system [Pugh et al, 1973], which does not include the variable of activity. As there is no sharp distinction between chronic active hepatitis and cirrhosis with activity; the latter has now been termed as active cirrhosis; and cirrhosis divided into active or inactive irrespective of the aetiological factor. In this study 60 cases of Modified Child A and B categories, with past history of bleeding varices, were subjected to splenectomy and devascularization. A wedge biopsy was submitted for histopathologic examination, to determine the degree of activity, the most marked of which has been termed grade III, moderate grade II, mid grade I and absent activity as cirrhosis grade 0. G 0 and G I cases passed through a smooth postoperative period, whilst G II and G III cases showed high mortality and morbidity rates. Numerical consideration of the activity grade in conjunction with Modified Child's score is tried. There is a statistically significant change in categorization and surgical outcome in the mortality and morbidity cases. A preoperative pathological grading of activity, via needle biopsy is hence advisable. This important parameter has to be considered in conjunction with the Modified Child's scoring system, as it reflects system, as it reflects itself heavily on both categorization and the surgical outcome