[Primary hepatic carcinoid]. / Primární jaterní karcinoid.

Primary hepatic carcinoid (PHC) is considered to be particularly sporadic diagnosis; in current world literature about 60 cases have been reported. Most of the patients present with abdominal pain, diarrhea, icterus, flush, weight loss or respiratory disease; even though the course of the disease might stay asymptomatic for a long time. An illuminating case of at presentation oligosymptomatic 72-year-old patient, which was after extensive examination based on OctreoScan and histological verification diagnosed to have generalized PHC, is reported. Paliative therapy with somatostatine analogues followed. At autopsy 8 months later the clinical diagnosis of PHC was confirmed. PHC is difficult to diagnose both due to radiological similarity to other hepatic lesions and demanding exclusion of other primary foci. The diagnosis of PHC is based on negative imaging techniques result in other possible localizations. Minimal symptomatology in stage of generalization, atypical primary localization and rapid progression is of interest in current case.

Urinary CXCL9 and CXCL10 levels correlate with the extent of subclinical tubulitis.

Subclinical tubulitis has been associated with the later development of interstitial fibrosis and tubular atrophy (IF/TA), leading to diminished allograft survival. The aim of this study was to investigate how concentrations of urinary CXC-receptor 3 (CXCR3) chemokines (i.e. CXCL4/9/10/11) and CCL2 relate to the extent of subclinical tubulitis. Using ELISA, urinary CXCR3 chemokines, CCL2 and tubular injury markers (i.e. urinary NGAL and alpha1-microglobulin [alpha1 m]) were measured in patients with stable estimated GFR >or=40 mL/min exhibiting normal tubular histology (n = 24), subclinical borderline tubulitis (n = 18) or subclinical tubulitis Ia/Ib (n = 22), as well as in patients with clinical tubulitis Ia/Ib (n = 17) or IF/TA (n = 10). CXCL9 and CXCL10 were significantly higher in subclinical tubulitis Ia/Ib than in subclinical borderline tubulitis (p