ABSTRACT
PIP: Analysis of 7 patients 20-30 years of age treated for hepatic cell carcinoma during the past 15 years at Massachusetts General Hospital indicated that 5 had an androgenous or exogenous disturbance of gonadal function. The 2 men in this series were taking methyltestosterone. Of the women, 2 had been taking oral contraceptives (OCs) for long durations, 1 had Stein-Leventhal syndrome, and 1 was infertile for 18 months. 3 of the 4 women with altered reproductive function had fibrolamellar carcinomas. These cases suggest that abnormalties of hypophyseal-gonadal endocrine metabolism can predispose to the development of hepatic cell carcinoma. Cessation of methyltestosterone or OC use and major hepatectomy apparently cured 3 of these patients. Although the data are consistent with a role for sex steroids in some cases of hepatic carcinogenesis, a case-control study would be needed to eliminate chance occurrence of fibrolamellar-variant cancer in the age group most likely to be using OCs. It is likely that hepatic carcinogenesis is a complex process involving genetic susceptibility, drug potency, regenerative urges, and the cooperation of promoters and co-carcinogens.^ieng
Subject(s)
Carcinoma, Hepatocellular/etiology , Contraceptives, Oral/adverse effects , Liver Neoplasms/etiology , Methyltestosterone/adverse effects , Adult , Carcinoma, Hepatocellular/therapy , Female , Humans , Liver Neoplasms/therapy , MaleSubject(s)
Legionnaires' Disease/complications , Nephritis, Interstitial/pathology , Respiratory Tract Infections/complications , Acute Kidney Injury/etiology , Adult , Anti-Glomerular Basement Membrane Disease/diagnosis , Antibodies, Bacterial/analysis , Diagnosis, Differential , Humans , Kidney Tubules/pathology , Legionnaires' Disease/diagnosis , Male , Nephritis, Interstitial/complications , Nephritis, Interstitial/diagnosisSubject(s)
Aspergillosis/pathology , Leukemia, Myeloid, Acute/pathology , Nose Diseases/pathology , Aspergillosis/complications , Aspergillosis/diagnosis , Bacterial Infections/complications , Bacterial Infections/diagnosis , Blood/microbiology , Diagnosis, Differential , Ecthyma/diagnosis , Humans , Leukemia, Myeloid, Acute/complications , Male , Middle Aged , Nasal Cavity/microbiology , Nasal Cavity/pathology , Nose Diseases/complications , Periapical Abscess/diagnosis , Sepsis/complicationsSubject(s)
Pulmonary Fibrosis/pathology , Adult , Bronchopneumonia/pathology , Diagnosis, Differential , Female , Humans , Lung Abscess/pathology , Pneumothorax/diagnosis , Pulmonary Embolism/pathology , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/etiology , Respiratory Distress Syndrome/diagnosis , Thoracic Injuries/complicationsABSTRACT
Colonic angiodysplasia is a vascular lesion of the colon that may become the source of low grade chronic or intermittently massive rectal bleeding. It is a lesion of the elderly, almost always found in the cecum and the ascending colon. Etiology and pathogenesis are unknown. The diagnosis can be made with angiography based on the demonstration of a vascular tuft and early opacification of draining veins. Right hemicolectomy is the mode of therapy. The lesions are minute, and in resected specimens they can be found only with special vessel injection techniques. Histologically, the lesions represent clusters of dilated vessels, mostly veins, in the mucosa and submucosa of the cecum and ascending colon.
Subject(s)
Colon/blood supply , Colonic Diseases/diagnostic imaging , Gastrointestinal Hemorrhage/etiology , Aged , Angiography , Cecal Diseases/diagnostic imaging , Colectomy , Colonic Diseases/complications , Colonic Diseases/surgery , Humans , Male , Middle Aged , Rectum , Vascular Diseases/complications , Vascular Diseases/diagnostic imaging , Vascular Diseases/pathologySubject(s)
Adrenal Gland Neoplasms/pathology , Carcinoma/pathology , Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/diagnosis , Adult , Carcinoma/complications , Carcinoma/diagnosis , Cushing Syndrome/pathology , Diagnosis, Differential , Edema/etiology , Hemorrhage/etiology , Humans , Hypertension/etiology , Liver Neoplasms/pathology , Male , Neoplasm MetastasisABSTRACT
A case of cholangiocarcinoma is described in a patient with underlying hepatic lithiasis and cholangitis. The possible pathogenesis of cholangiocarcinomas is discussed and the importance of endoscopic retrograde cholangiography in the diagnosis of this malignancy is emphasized.
Subject(s)
Adenoma, Bile Duct/etiology , Bile Duct Neoplasms/etiology , Bile Ducts, Intrahepatic , Cholangitis/complications , Cholelithiasis/complications , Liver Neoplasms/etiology , Adenoma, Bile Duct/diagnostic imaging , Aged , Bile Duct Neoplasms/diagnostic imaging , Cholangiography , Chronic Disease , Humans , Liver Neoplasms/diagnostic imaging , MaleSubject(s)
Carcinoma, Basal Cell/pathology , Facial Neoplasms/pathology , Fibroma/pathology , Jaw Diseases/pathology , Nevus/pathology , Odontogenic Cysts/pathology , Ovarian Neoplasms/pathology , Adolescent , Carcinoma, Basal Cell/diagnosis , Diagnosis, Differential , Facial Neoplasms/diagnosis , Female , Fibroma/diagnosis , Follow-Up Studies , Humans , Hydrocephalus/complications , Jaw Diseases/diagnosis , Nevus/diagnosis , Odontogenic Cysts/diagnosis , Ovarian Neoplasms/diagnosis , SyndromeABSTRACT
Long strictures of the intrapancreatic portion of the common bile duct were found in 6 patients with chronic pancreatitis. These strictures were responsible for painless obstructive jaundice, recurrent cholangitis, secondary biliary cirrhosis, and chronic abdominal pain difficult to distinguish from that caused by pancreatitis. Endoscopic retrograde cholangiopancreatography and intraoperative cholangiography were invaluable in making the diagnosis and in planning surgical correction. Decompression of the biliary tree by anastomosis of the gallbladder or common duct to the small intestine completely relieved symptoms and allowed liver function to improve significantly. Common duct stricture as a complication of chronic pancreatitis should be considered in the differential diagnosis of extrahepatic biliary obstruction and whenever surgical treatment of chronic pancreatitis is contemplated.
Subject(s)
Cholangitis/etiology , Cholestasis/etiology , Common Bile Duct , Liver Cirrhosis, Biliary/etiology , Pancreatitis/complications , Adult , Aged , Biliary Tract Diseases/diagnostic imaging , Biliary Tract Diseases/surgery , Cholangiography , Chronic Disease , Diagnosis, Differential , Humans , Middle AgedSubject(s)
Retroperitoneal Fibrosis/pathology , Adult , Biopsy , Diagnosis, Differential , Hodgkin Disease/diagnosis , Humans , Hydronephrosis/pathology , Hypertension, Renal/diagnosis , Hypertension, Renal/pathology , Male , Pyelonephritis/pathology , Renal Artery/abnormalities , Retroperitoneal Fibrosis/surgery , Retropneumoperitoneum , Ureter/pathology , Ureteral Obstruction/pathology , UrographySubject(s)
Foreign-Body Reaction/pathology , Peritonitis/pathology , Postoperative Complications/pathology , Starch/adverse effects , Adult , Diagnosis, Differential , Female , Foreign-Body Reaction/diagnosis , Granuloma/diagnosis , Granuloma/pathology , Humans , Omentum/pathology , Peritonitis/diagnosis , Postoperative Complications/diagnosisABSTRACT
A correlation between the use of halogenated anesthetic agents and liver necrosis is not yet established in man. In an attempt to resolve this dilemma, guinea pigs were immunized with a complex of guinea-pig albumin and trifluoroacetate (TFA), a common metabolite of halothane and fluorexene, and then exposed to halothane on multiple occasions. Histology and liver-function tests showed no difference in the incidence of liver damage between groups of animals immune to TFA with cellular immunity and untreated control animals. However, a difference in the liver enzyme levels was seen between controls and animals showing humoral immunity.
