TT virus-related acute recurrent hepatitis. Histological features of a case and review of the literature.

TT virus is a recently discovered virus, of which the pathogenetic potential is still uncertain. The present paper describes the histopathological features of a case of TT virus-related acute recurrent hepatitis. The patient is a 28-year-old woman with no history of drug or alcohol abuse, presenting with repeated episodes of hypertransaminasemia evidenced during the last 4 years. No other markers of viral or autoimmune disease were found. On histological analysis, the liver parenchyma showed a preserved architecture. The histological features were those of a mild acute hepatitis. The clinicopathological findings suggest th

[Splenic embolization and hepatic chemoembolization: combined transcatheter treatment of hepatocellular carcinoma in cirrhosis with hypersplenism]. / Embolizzazione splenica e chemioembolizzazione epatica: trattamento combinato transcatetere del carcinoma epatocellulare su cirrosi con ipersplenismo.

Liver cirrhosis with hypersplenism is often associated with HCC. In many such cases, chemoembolization (TACE) may be very difficult because of the high incidence of hemorrhagic complications due to treatment and/or following portal hypertension, as well as for poor hematologic tolerance to antiblastic drugs in cirrhotic patients. Six patients with nodular HCC and cirrhosis (Child B) with hypersplenism were treated by combined TACE and partial splenic embolization (PSE) to reduce splenic size and to improve hematologic and hepatic function rates. Actual and long-lasting (up to 6 months since TACE/PSE) positive results were observed in splenic size and in hepatic function synthesis, as well as on hematologic and hemocoagulation factors. The clinical-laboratory improvement following TACE/PSE allowed TACE to be completed in all cases, following the usual protocol based on 3 procedures. Therefore, in the patients with advanced/decompensated cirrhosis and hypersplenism associated with HCC, the combined one-step TACE/PSE treatment can be said to improve patients' tolerance to antiblastic drugs and to reduce the risk of hemorrhagic complications due to invasive radiologic procedures and/or to portal hypertension.

Investigations on intravascular coagulation in liver disease: souble fibrin monomer complexes in liver cirrhosis.

Souble fibrin monomer complexes (SFMC) have been quantitated in 18 patients with liver cirrhosis by means of plasma gel filtration on an agarose column. The concentration of SFMC (as related to total fibrinogen) was increased in cirrhotic patients. The difference between controls and patients, as well as the difference between compensated and decompensated cirrhotic subjects, was statisically significant. Although these data, together with the results of heparin administration in one reported case, suggest intravascular coagulation, some alternative explanations should also be considered.