scholarly journals Approach to the Liver Biopsy in the Patient With Chronic Low-Level Aminotransferase Elevations

2018 ◽  
Vol 142 (10) ◽  
pp. 1186-1190 ◽  
Author(s):  
Mark G. Ettel ◽  
Henry D. Appelman

Pathologists sometimes encounter a liver biopsy from an asymptomatic patient with unexplained low-level parenchymal liver enzyme elevations. These biopsies often have minor histologic changes but are otherwise almost entirely normal. This can lead to the quandary of whether or not the features are clinically meaningful and how one must formulate a diagnosis from the possibly nonspecific findings of a near-normal biopsy. The following discussion focuses on the histologic changes that can be seen in these biopsies and the practical issues involved in making a diagnosis that provides useful information to the clinician. The literature and textbooks addressing the histologic and clinical features of these cases are reviewed with an emphasis on the clinical implications of finding nonspecific histologic alterations in these patients.

1957 ◽  
Vol 33 (2) ◽  
pp. 209-224 ◽  
Author(s):  
H. Thaler ◽  
L. Benda ◽  
E. Rissel

Author(s):  
Nicole S. Winkler

Nipple discharge refers to expressible or spontaneous drainage of fluid from one or more duct orifices of the nipple. Discharge indicates excess fluid secretion into one or more ducts that will drain through an unobstructed duct orifice onto the nipple skin. The fluid content and appearance are important as they have clinical implications. Nipple discharge that is clear or bloody, unilateral (typically uniductal) and spontaneous (fluid discharges without breast or nipple compression) is considered suspicious for malignancy, though most cases are due to benign papillomas. This chapter, appearing in the section on nipple, skin and lymph nodes, reviews the key clinical features, associated imaging findings, imaging protocols and pitfalls, differential diagnoses, and management recommendations for patients presenting with nipple discharge. Topics discussed include clinical evaluation of nipple discharge, sonographic evaluation of ducts and nipple, ductography, intraductal mass, and papilloma.


Author(s):  
Eirini Kyrana ◽  
Anil Dhawan

The chapter on cystic fibrosis-associated liver disease discusses the pathophysiology and clinical features of this condition. In addition it covers diagnosis, including liver biopsy, transient elastography, the role of endoscopy and magnetic resonance retrograde cholangiopancreatography, and then discusses management including the role of transplantation.


2020 ◽  
Vol 26 (6) ◽  
pp. 691-702 ◽  
Author(s):  
Philippe Gailloud

Background Early anatomists suspected that the radiculomedullary veins draining the spinal cord had valves preventing their retrograde filling with anatomical casting material. Modern investigations have discarded the presence of true valves and introduced instead the notion of a pseudo-valvular configuration for which the term antireflux mechanism was coined in the 1970s. The angiographic anatomy of the antireflux mechanism has not been well documented so far. Methods This article discusses anatomical and clinical features of the antireflux mechanism with a series of 12 angiographic observations documenting the antireflux mechanism under normal and pathological circumstances. Results The antireflux mechanism divides radiculomedullary veins into intradural and extradural segments. While the structure of the antireflux mechanism is not yet fully clarified, it includes at least a tight narrowing of the radiculomedullary vein at its point of passage through the thecal sac, which is angiographically detectable and likely protects the intradural venous system from transient or persistent surges in venous pressure (e.g. sneezing, pregnancy). This tight narrowing of the antireflux mechanism likely also represents an obstacle to normal anterograde flow, potentially leading to venous stagnation and thrombosis. Conclusions The antireflux mechanism includes at least a tight narrowing of the radiculomedullary vein, which likely influences the development and clinical expression of low-flow spinal arteriovenous fistulas and might impact the spinal venous drainage even in the absence of arteriovenous shunts.


2020 ◽  
Vol 91 (6) ◽  
pp. AB333
Author(s):  
Hamzeh Saraireh ◽  
Thaer Abdelfattah ◽  
Puneet Puri ◽  
Robert Lippman ◽  
Pritesh R. Mutha ◽  
...  

2012 ◽  
Vol 10 (6) ◽  
pp. 657-663.e7 ◽  
Author(s):  
Thierry Poynard ◽  
Gilles Lenaour ◽  
Jean Christophe Vaillant ◽  
Frederique Capron ◽  
Mona Munteanu ◽  
...  
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