ABSTRACT
Background and Study Aims: Focal liver lesions are considerably detected in every day practice. Radiological imaging has a significant role in the detection and follow up of hepatic focal lesions. At times, the pathological study is absolutely necessary to confirm a definite diagnosis. The aim of this study was to estimate the probability that radiological scans to diagnose different types of focal liver lesions as primary imaging modalities are inconclusive. Methods: This study was carried out at National Hepatology and Tropical Medicine Research Institute, Egypt. Abdominal ultrasonography, triphasic computed tomography +/- magnetic resonant imaging and ultrasound guided percutaneos core biopsy of 42 patients with suspected hepatic focal lesions were carried out. Results: Out of 42 patients with liver focal lesions detected by transabdominal ultrasound and with inconclusive criteria by triphasic computed tomography +/- magnetic resonant imaging then confirmed by pathological examination, 8 were regeneration nodules, 18 hepatocellular carcinoma (HCC), 6 adenomas, 5 haemangiomas, 1 undifferentiated carcinoma,1 sarcoma., 2 abscesses and 1 dysplastic nodule. Conclusions: Ultrasound is a safe and rapid method of detecting hepatic focal lesions, also allowed ultrasound guided interventions. High proportions of inconclusive criteria by additional scans were observed in this study. In this case histopathology is recommended to confirm the diagnosis.
ABSTRACT
Background and Study Aims: Thrombocytopenia (TP) in chronic hepatitis C virus (HCV) is a common finding either directly due to viral infection of platelets or indirectly due to immune alteration triggered by the virus, the consequences of HCV- induced cirrhosis and portal hypertension, or induced by Interferon (IFN), the corner element of the standard of care (SOC) therapy for HCV. This study aimed to evaluate TP in patients with chronic HCV, and to evaluate the mutual effect between SOC and TP. Methods: The study was conducted on 209 patients with chronic HCV from Railway Hospital, Cairo. Patients were divided into two groups, Group (I): 144 patients who received SOC therapy, and Group (II): 65 patients who did not receive therapy. All patients were subjected to clinical examination, laboratory investigations, abdominal ultrasonography, and liver biopsy. Results: TP was a common finding (60/209; 28.7%), more in group I (33/ 60; 55%, mean= 124.8±16.2/ml), and was significantly worse in group II (mean= 99.7±36.3/ml, p=0.008). Along the course of treatment, 2 significant drops of platelet count took place, nadirs at W8 and W24. TP was significantly related to hepatitis activity and hepatic synthetic function, and not related to the viral load. Four cases developed severe TP, only 1 of them continued therapy on IFN dose reduction. Conclusions: TP is a common complication among HCV patients and along its SOC therapy, particularly influenced significantly by splenomegaly and advanced fibrosis.