Peritoneoscopic findings in 203 patients with Opisthorchis viverrini infection.

A study was conducted to determine the value of peritoneoscopy in the diagnosis of opisthorchiasis. Peritoneoscopic findings in 203 proven cases of Opisthorchis viverrini infection are presented. The authors found that cholangiocarcinoma is frequently encountered in patients presenting with prolonged jaundice and hepatomegaly as well as with the peritoneoscopic findings of dilated superficial intrahepatic bile ducts, a bile-stained liver surface and a markedly enlarged gallbladder.

Computed tomography in opisthorchiasis.

Opisthorchiasis is a relatively common disease in the northeast of Thailand. Fifteen cases were studied by CT, revealing interesting findings: 1. Fourteen cases had abnormal liver CT. 2. Dilatation of intrahepatic biliary tree was very common, in various degrees. 3. Most patients had co-existing cholangiocarcinoma, some with peritoneal seeding and/or regional lymph node involvement. Metastases to pancreas, adrenal gland, spleen, lung and pleura are occasionally seen at initial diagnosis. CT findings are very suggestive of this disease. However, diagnosis depends on history, clinical and parasitological bases.

Peritoneoscopy in the diagnosis of liver abscess. Experience with 108 cases during a 10-year period.

Among 4569 cases of peritoneoscopy performed in a period of 10 years (1972-1981), 108 patients with liver abscesses were encountered. The diagnosis of hepatic abscess was made on the basis of gross liver inspection and confirmed or disproved by needle puncture biopsy, histopathologic study, or surgery. Peritoneoscopy is a valuable procedure for the diagnosis of liver abscess. Liver aspiration under direct vision during peritoneoscopy yields more dependable material for the diagnosis of liver abscess than blind liver aspiration. Moreover, during peritoneoscopy one can choose more accurately the site for the insertion of the aspirating needle.

Carcinoma of the liver in Thailand, trends in two decades.

During the past 20 years, trends have been observed in primary hepatocellular carcinoma in Thailand. There is a definite increase in the association between HCC and cirrhosis of liver from 16.6% in 1958 to 50.78% in 1968 and 73.93% in 1978 series. The increase in percentage is associated with increase in mean age group from 44.61 +/- 9.77 in 1958, to 48.84 +/- 12.35 (p < 0.01) in 1978. This reflects the important role which hepatitis B plays in the etiology of HCC-associated with cirrhosis in Thailand. Also, the aggregation of people in the city of Bangkok may cause an increase in the hepatitis B carrier.

Ultrastructure of cholangiocarcinoma associated with opisthorchiasis.

An electron microscopic study was carried out on eleven surgical liver biopsy specimens obtained from patients with cholangiocarcinoma associated with opisthorchiasis. The tumor cells of histologically well differentiated cholangiocarcinoma had few cytoplasmic organelles. They contained relatively large nuclei, abundant free ribosomes and numerous groups of fine fibrils. Each cell was surrounded by a basement membrane. Numerous long microvilli were seen projecting into the glandular lumen. The moderately differentiated cholangiocarcinomatous cells exhibited increased organelle content, marked variation in the shape of the nuclei with deep cytoplasmic invagination into the nuclear membrane; there were small intranuclear pseudoinclusions, and shorter microvilli. The tumor cells showed intracellular microvillus-lined spaces, abundant free ribosomes, many fine fibrils and their surrounding basement membranes were incomplete. The ultrastructure of the poorly differentiated cholangiocarcinoma was similar to that of the moderately differentiated tumor, except for fewer microvilli, abundant cytoplasmic organelles, and ill-defined or absent basement membrane.