ABSTRACT
Aim: To evaluate the association between biochemical, virologic and histologic features in patients with HBeAg-negative chronic hepatitis B [CHB]
Background: Hepatitis-B e-antigen [HBeAg]-negative is common in Iran, is progressive with poor prognosis. Therefore, it seems necessary to perform a comprehensive evaluation of different spectrum of laboratory measurements accompanying histological findings
Methods: HBeAg- negative CHB patients referring to two university hospitals during two years were enrolled. Alcohol consumption, liver mass, fatty liver and positive results of Anti HDV, Anti HCV or Anti HIV were excluded. The relationship between viral loads, liver enzymes [old and new cutoffs] and histopathological features was analyzed using descriptive and analytic statistical methods
Results: A total of 150 HBeAg-negative CHB [males=110, mean age=38.44 +/- 11.34 years] were assessed. ALT had a significant relation with the logarithm of serum HBV-DNA [P<0.0001], grade and stage on liver biopsy [P<0.001, P=0.034, respectively]. Serum viral load, AST and ALT were independent predictors of histological grade, age was the only independent predictor of the stage of liver fibrosis. There was a significant relationship between serum ALT and stage of liver fibrosis [P<0.0001] when new cutoff values for ALT were considered. We found that age had a significant relation with histological grade but it showed a reverse relation with ALT levels [P=0.009]
Conclusion: In HBeAg-negative CHB, AST had a better prediction for liver necrosis and inflammation. Age could be an independent predictor for liver fibrosis. New cutoff values for ALT had superiority over conventional values to identify higher risk of liver fibrosis
ABSTRACT
Bile duct adenoma [BDA] is a rare neoplasm of bile ducts with various clinical manifestations and imaging appearances. A few cases of BDA and their predisposing factors have been described. We report a 35-year-old woman with right upper quadrant pain who consumed oral contraceptive pills. Ultrasound study revealed three hypoechoic subcapsular liver masses; two of them were hypodense in computed tomography. Fine needle biopsy of the largest mass showed bile duct adenoma. Liver masses disappeared after discontinuing the pills over a 2-year follow-up. BDAs can manifest in imaging. Although previous studies have not reported tumor resolution over a follow-up period, we suggest paying more attention to predisposing factors in order to give an opportunity for tumor resolution by risk factor elimination
ABSTRACT
There is still been no report of splenic involvement in the wake of colon cancer. In this case, air was seen in the spleen and liver following the penetration of colon cancer to the continuous spleen. Colon cancers always do not present with clear and common symptoms. Some times with a non-specific and uncommon symptoms and signs present that would be amazed physicians and researchers. It is very rare that we present, a middle aged man who presented with abdominal pain and rectal bleeding and in our investigation was seen air in spleen and liver in CTscan study. After surgery we found that air in spleen and liver is due to infiltration and invasion of splenic flexure colon cancer to spleen. Has had no cases of invasive colon cancer that causes the air in the spleen and liver have been reported