Prevalence study of metastases in cirrhotic livers.

BACKGROUND/AIMS: Metastatic carcinoma is rarely seen in cirrhotic livers. The aim of this study is to verify the prevalence of metastases in cirrhotic liver comparing cirrhotic patients with a control group. METHODOLOGY: This study is based on 7,092 necropsies performed in two big Hospitals of Porto Alegre, Brazil. Two thousand seven hundred and three consecutive autopsies were analyzed to study the frequency of liver metastases in cirrhotic patients. This material included 111 cases of liver cirrhosis. A control group was obtained by matching selection to compare the prevalence of extrahepatic cancer and hepatic metastases between the two groups. RESULTS: Our analysis showed that hepatitis metastases, as well as extrahepatic cancer, are less frequently seen in the cirrhotic liver (no cases of hepatic metastases and 6 of extrahepatic cancer) compared to the control group (10 cases of hepatic metastases and 21 of extrahepatic cancer), this difference being statistical significant (p < 0.05). CONCLUSIONS: Our results show that, in our sample, hepatic metastases are less common in cirrhosis of the liver than in liver without cirrhosis, this result may be due to the fact that patients with cirrhosis present less extrahepatic cancers and cirrhotic livers may represent an unfavorable site for metastatic growth.

Síndrome hepatopulmonar / Hepatopulmonary syndrome

A presente revisäo enfatiza os aspectos relacionados às alteraçöes pulmonares subseqüentes à hepatopatia crônica, mais recentemente chamada síndrome hepatopulmonar, que se caracteriza por presença de doença hepática, associada a aumento do gradiente alvéolo-arterial e dilataçöes vasculares intrapulmonares. Säo abordados aspectos históricos bem como relacionados à fisiopatogenia e métodos diagnósticos empregados. O emprego de gasometria arterial em repouso e com oxigênio a 100 por cento para excluir "shunt" intrapulmonar assim como o emprego do ecocardiograma com contraste para avaliar o tipo de "shunt" säo opçöes diagnósticas menos invasivas que a arteriografia pulmonar. A difusäo com monóxido de carbono pode ser...