Abdominal Ultrasonography in Myelofibrosis

The findings at abdominal ultrasonography (US) in 40 patients with myelofibrosis were reviewed, 20 patients being examined at initial diagnosis and 31 at later stages. Splenomegaly was found in 80% at initial diagnosis and in 97% at later stages. The spleen of 2 patients appeared homogeneously hypoechoic and inhomogeneous in one. Focal splenic lesions were seen in 5, and calcifications in 6. Mixed splenic lesions proved to be metastases in one and hyperechoic lesions in another patient were due to extramedullary hematopoiesis. Hepatomegaly was found in 25% at primary diagnosis and in 39% at later stages. Focal hepatic lesions were seen in 7 patients, and proved to be metastases in 3. The focal lesions in 2 of these patients were extramedullary hematopoiesis, which was hypoechoic in one and hyperechoic in the other. Ascites was seen in 4 patients and lymphadenopathy in one. US could not reliably differentiate between extramedullary hematopoiesis and malignancy. Fine-needle biopsy may be performed for definitive diagnosis.

Download Full-text

Role of MRI in Detecting and Characterizing Small Hepatic Focal Lesions

QJM ◽

10.1093/qjmed/hcab106.035 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Rania Ali Maarouf ◽

Ali Haggag Ali ◽

Mahmoud Abdelatif Onsy

Keyword(s):

Tumor Staging ◽

Left Lobe ◽

Diagnostic Process ◽

Liver Imaging ◽

Focal Lesions ◽

Focal Hepatic Lesions ◽

Malignant Lesions ◽

Hepatic Lesions ◽

The Right

Abstract Background Despite the recent advances in liver imaging, the detection and characterization of small hepatic focal lesions is still a real challenge. Particularly in cancer patients where the characterization of a small HFL as thus the precise tumor staging is critical for optimal treatment planning. Aim of the Work To explore the effectiveness, and hence the clinical utility, of MRI detection and characterization of small focal hepatic lesions either only discovered on MRI or as a further work up of CT/US-indeterminate lesions. Patients and Methods We reviewed our database for individuals who underwent liver MR imaging between March 2018 and March 2019 for the evaluation of small hepatic lesions that were discovered for the first time or had been previously visualized on routinely performed CT and had been considered indeterminate. Results The present study included 44 patients of which 26 were males (59.1%) and 18 were females (40.9%). The age range of the study group was 19 to 77 years. The mean age for Malignant lesions was 51 years. The right lobe of liver was involved in 23 cases (52.3%), left lobe in 5 cases (11.4%) and both lobes in 16 cases (36.4%). There were 30 (68.18%) benign, 13 (29.54%) malignant lesions and 1 (2.3%) indeterminate, hemangiomas were predominant in benign lesions whereas hepatocellular carcinomas were predominant in malignant lesions. N'TRI could characterize 92% cases. Conclusion The diagnostic process of small hepatic focal lesions, either detection or characterization or both, continues to represent a challenge. Contrast-enhanced MR can accurately detect and characterize majority of small hepatic focal lesions.

Download Full-text

Ascitic Fluid Cytokines in Chronic Liver Disease: A Possible Prognostic Tool

Digestive Diseases ◽

10.1159/000514356 ◽

2021 ◽

Author(s):

Shimaa atta ◽

Manal Kamel ◽

Wafaa Mansour ◽

Taghreed Hussein ◽

Kesmat Maher ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Ascitic Fluid ◽

Serum Levels ◽

Malignant Ascites ◽

Focal Lesions ◽

Prognostic Tool ◽

Significant Difference ◽

Focal Hepatic Lesions ◽

Hepatic Lesions ◽

Fluid Levels

Introduction: Malignant ascites results from imbalance between protein in the peritoneal cavity and absorption of fluids via the lymphatic system. More than twenty interleukins are known to play an important role in the protection against tumors. Materials and methods: Ascitic fluid IL1B, IL2, IL4, IL6, IL10, TNFα, and IFNγ levels were assessed in forty-five patients with liver cirrhosis and ascites as judged by histopathological and ultra-sonographic findings. They were divided into two groups according to presence of hepatic focal lesions. Ten patients with focal hepatic lesions were randomly selected and subjected to analysis of serum levels of IL2 and IL10. Results: Ascitic fluid IL-4, IL-6 and IL-10 levels were found to be significantly higher in patients with hepatocellular carcinoma than patients with cirrhosis. TNFα, and IFNγ were also found to be higher in hepatocellular carcinoma than patients with cirrhosis but with no significance. On the other hand, there was no significant difference in levels of IL1B and IL2 between the two groups. Ascitic fluid IL2 and IL10 levels were found to be higher in ascitic fluid than in serum of the same patients. Conclusion: Ascitic fluid levels of IL-4, IL-6 and IL-10 are higher in hepatocellular carcinoma patients than patients with cirrhosis alone. Levels of ascitic fluid IL2 and IL10 were proved to be a better prognostic tool than their levels in sera of the same patients. To conclude; patients with cirrhosis may be subjected to schedualed examination of ascitic fluid cytokine to predect transformation into hepatocellular carcinoma.

Download Full-text

Usefulness of contrast-enhanced ultrasound using perfluorobutanecontaining microbubbles as a planning for percutaneous biopsies of focal hepatic lesions: a prospective feasibility study

Medical Ultrasonography ◽

10.11152/mu-1744 ◽

2019 ◽

Vol 21 (2) ◽

pp. 109 ◽

Cited By ~ 3

Author(s):

Sang Min Lee ◽

Jung Hoon Kim ◽

Hyun Kyung Yang ◽

Hyo-Jin Kang ◽

Joon Koo Han

Keyword(s):

Target Lesion ◽

Technical Failure ◽

Mr Images ◽

Point Scale ◽

Focal Lesions ◽

Technical Feasibility ◽

Contrast Enhanced ◽

Focal Hepatic Lesions ◽

The Mean ◽

Hepatic Lesions

Aims: To determine whether contrast-enhanced US using perfluorobutane-containing microbubbles (SEUS) would be helpful for planning a hepatic biopsy.Material and methods: This prospective study included 40 patients who planned to undergo hepatic biopsy for focal hepatic lesions. All patients underwent B-mode US followed by SEUS. The radiologist evaluated the number of detected lesions, presence of necrosis, conspicuity of target lesion and technical feasibility using 4-point scale. Technical failure and occurrence of change of the target were also assessed. Computer tomography (CT) or magnetic resonance (MR) images were the reference techniques. Results: The mean number of lesions detected on CT and MR images was 6.5±8.4. In 20 (50%) of 40 patients, more focal lesions were detected on SEUS. Targeted lesion was changed in sixpatients (15%) on SEUS. Mean number of detected lesions on SEUS was significantly higher comparing with B-US (5.1±6.2 vs. 2.8±3.8, p<0.001). Conspicuity of the targeted lesion was improved in 67.5% (27 of 40) on SEUS and significantly more visualized than B-US (3.6±0.8 vs. 2.8±0.9, p<0.001). In 7 more patients the necrosis within the lesion was visualized (17.5%) using SEUS. The technical feasibility on SEUS was significantly higher than B-US (2.3±1.0 vs. 3.3±0.9, p<0.001). Technical failure was observed in only one patient (2.5%).Conclusions: SEUS is a helpful technique for planning the hepatic biopsyin terms of detection, improving lesion conspicuity, tumor viable portion assessment and consequently higher operator confidence, compared with B-US.

Download Full-text

Hepatocellular carcinoma presenting with pyrexia and leukocytosis: A case report

Medicinski pregled ◽

10.2298/mpns1702048s ◽

2017 ◽

Vol 70 (1-2) ◽

pp. 48-52

Author(s):

Srdjan Stosic ◽

Sanja Stojanovic ◽

Stevan Idjuski ◽

Jelena Stosic

Keyword(s):

Hepatocellular Carcinoma ◽

Case Report ◽

Liver Abscess ◽

Therapeutic Response ◽

Left Lobe ◽

Focal Lesion ◽

Abdominal Ultrasonography ◽

Focal Hepatic Lesions ◽

Hepatic Lesions

Introducion. This type of hepatocellular carcinoma is characterized by fever and persistent leukocytosis. Case report. This is a report of a patient with a long term fever accompanied by persistent leukocytosis. Abdominal ultrasonography revealed a focal lesion in the left hepatic lobe, whereas, computed tomography/magnetic resonance imaging findings were consistent with a liver abscess. The patient received therapy for liver abscess, without improvement. He underwent left lobe segmentectomy 3, with histological features of hepatocellular carcinoma (pseudoglandular type). Conclusion. In patients with focal hepatic lesions accompanied with raised temeparature and persistent leukocytosis, without adequate therapeutic response, this clinicopathological type of hepatocellular carcinoma should be considered.

Download Full-text

Significance of posterior acoustic enhancement ultrasonographic findings in the diagnosis of hepatocellular carcinoma

Medicinski pregled ◽

10.2298/mpns1906160s ◽

2019 ◽

Vol 72 (5-6) ◽

pp. 160-164

Author(s):

Jelena Stosic ◽

Srdjan Stosic ◽

Biljana Kukic ◽

Mladjan Protic

Keyword(s):

Hepatocellular Carcinoma ◽

Retrospective Study ◽

Liver Disease ◽

Ultrasound Examination ◽

Significant Finding ◽

Focal Lesions ◽

Hepatocellular Carcinomas ◽

Focal Hepatic Lesions ◽

Patients At Risk ◽

Hepatic Lesions

Introduction. On ultrasound, hepatocellular carcinoma presents with nodular or multinodular lesions of different size and echostructure, sometimes with a surrounding halo, and lateral acoustic shadows or posterior acoustic enhancement. The aim of this study was to determine the incidence of posterior acoustic enhancement in hepatocellular carcinoma. Material and Methods. This retrospective study included 120 patients with pathologically verified hepatocellular carcinoma who had undergone ultrasound examination (using real time ultrasounds from different manufacturers, with 3.5 and 5 MHz probes). Ultrasound imaging focused on the size and appearance of the focal lesions, i. e. echostructure and presence or absence of posterior acoustic enhancement as areas of increased echogenicity behind the lesion. Results. Posterior acoustic enhancement was observed in 47.3% of all nodular hepatocellular carcinomas, whereas this ultrasound phenomenon was statistically significantly more common in the group of tumors from 3 to 5 cm in size. In the group of multinodular tumors, posterior acoustic enhancement was found in 70% of cases. Conclusion. The presence of posterior acoustic enhancement in the detection of focal hepatic lesions may be a significant finding in the diagnosis of hepatocellular carcinoma, especially in patients at risk for developing hepatocellular carcinoma (cirrhosis and chronic liver disease), as well as in monitoring interval growth in size of focal lesions using this ultrasound phenomenon.

Download Full-text