Hepatocellular Carcinoma in a non-B non-C Non-alcoholic Steatohepatitis (NBNC-NASH HCC)

Introduction: Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumour, which commonly occurs in those with underlying chronic liver problems mainly cirrhoric liver with viral hepatitis (HBV and HCV) as the most common aetiological agent. HCC could also arise from non-chronic liver, which include non-B non-C (NBNC) hepatitis, which is different in pathogenesis, epidemiology and prognosis. This disease entity would include the commonly benign fatty liver leading to non-alcoholic steatohepatitis (NASH) and HCC as sequale. Methods: We present a case of non-B non-C HCC arising from a fatty liver in a non-alcoholic patient. Literature search was done with special emphasis on this disease. Conclusion: The incidence of NBNC HCC demonstrates an increasing trend, making it an important entity to be recognised early. A good understanding of this incidence would make it possible to predict the outcome, especially as the prognosis of non-B non-C HCC is fairly good if the HCC is found at an early stage

Whole Body Imaging Using 18-Fluorine Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) with or without Contrast Enhanced Computed Tomography (CT) in Dignosing Arteritis

Introduction: Takayasu's Arteritis and Horton's Arteritis are two rare cases of auto-immune complex diseases resulting in sterile inflammatory reactions affecting the wall of large and medium sized arteries. Various radiological and interventional methods employed are inconclusive and become diagnostic only when complications begin to set in. The new non-invasive hybrid Positron Emission Tomography Computed Tomography (PET/CT) using 18Florine-Fluorodeoxyglucose (18F-FDG) imaging technique could detect arteritis in an early clinical stage when routine conventional cross-sectional imaging was inconclusive. Method: Two cases from Klagenfurt Hospital, Austria and Milan General Hospital, Italy were compared with image acquisition being done in the respective hospitals. In Klagenfurt, PET/CT image acquisition was performed using intravenous contrast administration and in Milan, CT parameters were used as attenuation correction and anatomical correlation of PET images. Results: CT performed using both methods, with or without iodinated contrast media, were useful in detecting arteritis. Conclusion: It is concluded that PET/CT aside from being a useful tool in cancer imaging, is also useful for pyrexia of unknown origin. PET/CT should be employed early in managing this clinical condition where arteritis is a possible diagnosis.