ABSTRACT
Acute liver failure (ALF) is a clinical syndrome associated with significant morbidity and mortality with a highly unpredictable outcome. We retrospectively analyzed 71 ALF patients (53 males; mean age = 27.5 ± 15.6 years) that underwent transjugular liver biopsy (TJLB) at our institution. The aims of this study are (i) to report our experience with TJLB in these patients, and (ii) to examine the role of liver histology in predicting their outcome. We also compared the histopathological findings between TJLB and explanted liver specimens in 31 patients who underwent liver transplantation (LT). Biopsy specimens were satisfactory for histopathological analyses in 69 (97.1%) patients, confirmed the clinical diagnosis in 56 (81.2%) patients, and altered the diagnosis in 13 (18.8%) patients. Minor complications were encountered in four (5.6%) patients. Percentage of hepatocyte necrosis was the only histological parameter that has significant discriminatory prognostic value, with no survivors having >75% necrosis without LT. In conclusions, TJLB is a safe technique for obtaining liver tissue in both adult and pediatric patients with ALF. Histological characteristics, mainly etiological diagnosis and degree of hepatocyte necrosis may assist in clinical decision-making for need of LT in these patients.
Subject(s)
Biopsy, Needle/methods , Liver Failure, Acute/pathology , Liver/pathology , Adolescent , Adult , Child , Child, Preschool , Female , Hepatocytes/pathology , Humans , Infant , Liver/surgery , Liver Failure, Acute/etiology , Liver Failure, Acute/mortality , Liver Failure, Acute/surgery , Liver Transplantation , Male , Middle Aged , Necrosis , Prognosis , Retrospective Studies , Severity of Illness Index , Young AdultABSTRACT
BACKGROUND: Giant cell tumors are rare and highly malignant tumors of the pancreas. Based on two distinct cell populations, they have been divided into two subtypes corresponding to the osteoclast-like giant cell tumor and the pleomorphic giant cell carcinoma of the pancreas. Distinctive imaging features of the tumors remain uncharacterized. Surgical removal is the only appropriate treatment for them, but responses to chemotherapy or radiotherapy remain undocumented. METHODS: Clinical, radiological, histopathologic, and immunohistochemical features of two cases of giant cell tumor of the pancreas are presented along with a brief review of the literature. RESULTS: En-bloc resection was done successfully in both cases. The patient with an osteoclast-like giant cell tumor remained disease-free with no clinical or radiological evidence of recurrence at 6 months after surgery. However, the patient with the pleomorphic type died 4 months later due to diffuse pulmonary metastasis. CONCLUSIONS: En-bloc surgical resection is the only appropriate treatment for giant cell tumors. The overall prognosis of these tumors is poorer than that of pancreatic ductal adenocarcinoma, especially the pleomorphic type. More studies are required to document the management and outcomes of the tumors.
Subject(s)
Giant Cell Tumors/diagnosis , Giant Cell Tumors/pathology , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/pathology , Adult , Fatal Outcome , Giant Cell Tumors/surgery , Humans , Male , Middle Aged , Pancreatic Neoplasms/surgery , Prognosis , Treatment OutcomeABSTRACT
Metastasizing pleomorphic adenoma (PA) is a rare condition displaying benign histological features as of PA in the metastatic lesion. The present study report a case of 46 years old male presented with space occupying lesion in the right lobe of liver. Patient underwent extended right hepatectomy for space occupying lesion in liver and the histological features were suggestive of metastatic benign pleomorphic adenoma. Surgical resection is the treatment of choice for both primary and metastatic lesion.
