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1.
Journal of Liver Cancer ; : 174-181, 2017.
Article Dans Coréen | WPRIM | ID: wpr-100916

Résumé

Heterogeneous features of liver cancer can mimic liver abscess. Therefore it is essential to double-check tumor markers in the diagnosis of liver abscess. Herein, we report a case of combined hepatocellular-cholangiocarcinoma (cHC) occurred in an unrecognized chronic hepatitis B patient initially misdiagnosed as liver abscess. A 49-year old male initially presented with chill, right upper quadrant pain, and a liver mass. Mass showed peripheral enhancement in arterial phase of computed tomography, which was not typical for hepatocellular carcinoma (HCC). Strikingly elevated alpha-fetoprotein and fine needle aspirated pathology revealed HCC. Despite discordant image findings he was treated with transarterial chemoembolization. He was treated with sorafenib due to metastatic retrocaval lymphadenopathy afterwards. The mass presumed to be HCC progressed with sorafenib. It was surgically resected and he was finally confirmed as cHC. Discordant tumor markers with presumptive image findings should prompt the suspicion of rare type of primary liver cancer, the cHC.


Sujets)
Humains , Mâle , Alphafoetoprotéines , Marqueurs biologiques tumoraux , Carcinome hépatocellulaire , Diagnostic , Hépatite B chronique , Foie , Abcès du foie , Abcès hépatique à pyogènes , Tumeurs du foie , Maladies lymphatiques , Aiguilles , Anatomopathologie
2.
Korean Journal of Medicine ; : 32-36, 2016.
Article Dans Coréen | WPRIM | ID: wpr-149393

Résumé

Acute liver failure (ALF) is a medical emergency triggering an urgent need for liver transplantation. The most common causes of ALF are drug- and virus-associated hepatitis, but hematological malignancies such as an aggressive natural killer cell lymphoma (ANKL) can uncommonly cause ALF. A 50 year-old male presented with ascites, jaundice, and encephalopathy. The ascitic fluid had a serum-ascites albumin gradient of 0.3 g/L, and contained atypical lymphocytes, which were positive for CD3. Computed tomography revealed mild hepatomegaly and multiple nodules in both lobes of the liver. A liver biopsy showed that the liver parenchyma had been infiltrated by malignant lymphoid cells, and exhibited marked sinusoidal dilatation. Immunohistochemically, the lymphoid cells were positive for CD3, CD56, and Epstein-Barr virus-encoded small RNA. The patient was diagnosed with ANKL causing ALF, and died on hospital day 12. This case shows that infiltration of the liver with ANKL can (rarely) cause ALF.


Sujets)
Humains , Mâle , Ascites , Liquide d'ascite , Biopsie , Dilatation , Urgences , Tumeurs hématologiques , Hépatite , Hépatomégalie , Ictère , Cellules tueuses naturelles , Foie , Défaillance hépatique , Défaillance hépatique aigüe , Transplantation hépatique , Lymphocytes , Lymphomes , ARN
3.
The Korean Journal of Gastroenterology ; : 51-55, 2014.
Article Dans Coréen | WPRIM | ID: wpr-87788

Résumé

Gallbladder tuberculosis is an extremely rare disease that is rarely reported in the literature. Arriving at the correct diagnosis of gallbladder tuberculosis is difficult, and it is usually made by histopathologic examination after cholecystectomy. However, due to the low sensitivity of acid-fast stain and culture result, diagnosing gallbladder tuberculosis is still demanding even after tissue acquisition. To overcome this problem, tuberculosis-polymerase chain reaction (TB-PCR) is performed on the resected specimen, which has high sensitivity and specificity. A 70-year-old female who had previously undergone total gastrectomy for advanced gastric cancer was admitted with right upper quadrant pain. Abdominal ultrasonography and computed tomography revealed acute cholecystitis without gallstones or sludge. She underwent cholecystectomy and the histopathologic finding of the specimen showed chronic active cholecystitis without gallstones or sludge. Because she was suspected to have pulmonary tuberculosis, TB-PCR was also performed on the resected gallbladder. TB-PCR showed positive reaction for Mycobacterium tuberculosis and we could diagnose it as gallbladder tuberculosis. Herein, we present a case of gallbladder tuberculosis diagnosed by TB-PCR from resected gallbladder.


Sujets)
Sujet âgé , Femelle , Humains , Antituberculeux/usage thérapeutique , Cholécystite aigüe/diagnostic , ADN bactérien/analyse , Mycobacterium tuberculosis/génétique , Réaction de polymérisation en chaîne , Tomodensitométrie , Tuberculose/diagnostic
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