• Title/Summary/Keyword: 간세포암종

Search Result 37, Processing Time 0.022 seconds

Fine Needle Aspiration Cytology of Hepatocellular Carcinoma - A Study on 247 Cases - (간세포암종의 세침흡인 세포학적 소견 - 247예에 대한 연구 -)

  • Lee, Kwang-Gil;Lee, Jong-Tae;Choi, Soo-Im;Park, Chan-Il
    • The Korean Journal of Cytopathology
    • /
    • v.1 no.1
    • /
    • pp.1-17
    • /
    • 1990
  • Hepatocellular carcinoma (HCC) is malignant tumor frequently occurring in Koreans. There have been few reports regarding the cytologic findings of fine needle aspiration (FNA) of HCC. Most have suggested a diagnostic problem in the cytology distinguishing HCC from some benign hepatic lesions-for example, a regeneration nodule in cirrhosis and liver cell adenoma. In spite of its high frequency in Korea, no cytologic study has been reported, concerning the FNA of HCC. In an attempt to achieve cytologic criteria for the diagnosis of HCC, the authors studied retrospectively cytopathologic findings of 247 cases of HCC. These cases were confirmed either by histoiogic examination including lobectomy, biopsy, or ceil block material, or, when tissue diagnosis was unavailable, by a high serum alpha-fetoprotein level (over 400 I. U.). All aspiration smears were stained by the Papanicolaou method. In each case, the smears were analyzed for cell patterns and various cytomorphology of the tumor cells. The smear background was assessed for the presence of tumor cell necrosis and inflammatory components and compared to that of metastatic carcinomas. The cell patterns were classified as trabecular, acinar, dispersed, and irregular. The cytologic parameters analyzed included the degree of nuclear atypia and the presence of mitoses, intranuclear cytoplasmic inclusions, nucleolar prominency, endothelial lining, multinucleated giant cells, eosinophiic globules, bile, and Mallory body. Most of the FNA of HCC showed markedly cellular smears. The tumor cells were most frequently arranged in a trabecular pattern (80.3%). The irregular (12.6%), the acinar (5.5%), and the dispersed patterns (1.7%) followed in decreasing frequency. Individual hepatoma cells were larger than normal liver cells. However, they had morphologic features characteristic of the hepatic cells the cells were round or polygonal, their cytoplasm was abundant and granular with eosinophilic or amphophilic stainability, and their nuclei were round to oval, located centrally, and tended to have prominent nucleoli. Anaplasia and pleomorphism of tumor cells were generally mild to moderate. These findings existed even in very well differentiated cases. Mitotic figures were present in about 85% of the cases. Prominent nucleoli were observed only in about half the cases. The frequency of other cytologic features was as follows intranuclear cytoplasmic inclusion in 86.8% : endothelial lining in 56.1% : bile in 19.8% : and giant cells in 60.1%. Clear cells were often present in 11.7%, Most aspiration smears of HCC displayed clean background without necrosis or inflammatory material in contrast to the dirty, necrotic background of metastatic cancers and cholangiocarcinomas. Based on the above mentioned features, it is suqqested that the cytologic critieria most important for the diagnosis of HCC include a markedly cellular smear, trabecular pattern, hepatocytoid appearance of tumor cells, endothelial lining, the presence of bile, giant cells, intranuclear cytoplasmic inclusions, and prominent nucleoli, Among these, trabecular pattern, endothelial lining, giant cells and clean smear background are points to be considered in differentiating HCC from metastatic and cholangiocellular carcinoma.

  • PDF

Hepatoid Adenocarcinoma of the Stomach with Liver Metastasis (간 전이를 동반한 위의 간양 선암 1예)

  • Kwon Wooil;Park Do Joong;Lee Hyuk-Joon;Kim Woo Ho;Yang Han-Kwang;Choe Kuk Jin;Lee KuhnUk
    • Journal of Gastric Cancer
    • /
    • v.5 no.2
    • /
    • pp.127-132
    • /
    • 2005
  • A hepatoid adenocarcinoma of stomach, a subtype of gastric cancr, is characterized by a histologic resemblance to a hepatocellular carcinoma and $\alpha$-feto protein production. Another feature is early metastasis to the liver and lymph nodes, thus revealing a poor prognosis. We report a case of a hepatoid adenocarcinoma of the stomach with liver metastasis. A 52-year-old male visited our hospital with a chief complaint of indigestion. Gastroscopic examination showed a Borrmann type-II lesion on the lesser curvature of the antrum. The CT scan showed a suspected advanced gastric cancer with liver metastasis. The serum AFP level was 123 ng/ml. A radical subtotal gastrectomy and a right hemihepatectomy were performed simultaneously. Pathologic examination confirmed the lesion to be confined to the submucosa. The gastric lesion was a hepatoid adenocarcinoma, and the hepatic lesion was a metastatic adenocarcinoma from the stomach. Therefore, he was classified as having stage IV (T1N1M1) gastric cancer. In cases of a hepatoid adenocarcinoma of the stomach, even patients with early gastric cancer can be staged into the poor prognostic group.

  • PDF

Herbal Medicine for Liver Cancer: A Protocol for Systematic Review and Meta-Analysis (간암에 대한 한약치료: 체계적 문헌고찰 및 메타분석의 프로토콜)

  • Kwon, Seungwon;Song, Ga Yeon;Yang, Seung-Bo
    • The Journal of Internal Korean Medicine
    • /
    • v.43 no.4
    • /
    • pp.559-566
    • /
    • 2022
  • Introduction: The aim of this systematic review is to provide evidence confirming the efficacy and safety of herbal medicines used in the treatment of liver cancer. Methods: The review will include randomized clinical trials that compared herbal medicines used as treatments for liver cancer with other therapies, such as placebos and Western medicine. Only randomized controlled trials will be included in this review, and all types of herbal medicine will be evaluated. Eleven electronic databases will be searched from the inception date: the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, AMED, CINAHL, one Chinese database (CNKI), and five Korean databases (OASIS, DBpia, RISS, KISS, and NDSL). The selection of studies, data extraction, and management will be performed independently by four researchers. Methodological quality, including the risk of bias, will be assessed using the Cochrane risk-of-bias assessment tool. Results: The review of current evidence for the effectiveness of herbal medicine for liver cancer will be summarized and quantitatively analyzed. Conclusions: Our systematic review will provide evidence of the efficacy of herbal medicines as treatments for liver cancer. This evidence will provide useful information for practitioners and patients in the fields of oncology and complementary medicine.

Chronic Hereditary Tyrosinemia Type I with Novel Mutation in FAH Gene (FAH gene novel mutation을 가진 만성형 Hereditary tyrosinemia 1형)

  • Yang, Sungmin;Choi, Hyo Won;Kang, Yun Koo;Lee, Jin-Sung;Namgoong, Mee Kyung
    • Journal of The Korean Society of Inherited Metabolic disease
    • /
    • v.20 no.2
    • /
    • pp.55-62
    • /
    • 2020
  • A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

Long Term Effects of Lamivudine and Adefovir dipivoxil in Chronic Hepatitis B Patients on the Development of Hepatocellular Carcinoma (만성 B형간질환에서 HBV백신 및 항바이러스치료가 간세포암종 발생에 미치는 효과)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
    • /
    • v.25 no.1
    • /
    • pp.1-18
    • /
    • 2008
  • Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of $10^4$ copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the $21^{st}$ century.

  • PDF

Antihepatotoxic effect of ethanol extracts from steam-dried ginseng berry on ᴅ-galactosamine/lipopolysaccharide-sensitized mice (ᴅ-galactosamine/lipopolysaccharide로 감작된 급성간독성 마우스 모델에서 인삼열매추출물의 간독성 개선 효과)

  • Jang, Su Kil;Park, Jun Sub;Ahn, Jeong Won;Jo, Boram;Kim, Hyun Soo;Kim, JeongHoon;Kim, Sang Yun;Park, Jung Youl;Lee, Do Ik;Park, Hee Yong;Joo, Seong Soo
    • Korean Journal of Food Science and Technology
    • /
    • v.49 no.6
    • /
    • pp.676-684
    • /
    • 2017
  • The present study aimed to examine the hepatoprotective effects of ethanol extracts from steam-dried ginseng berry (SGBE) in both $\text\tiny{D}$-Galactosamine/Lipopolysaccharide ($\text\tiny{D}$-GalN/LPS)-sensitized mice and in vitro models. Our results clearly demonstrated that SGBE significantly reduced the level of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and lactate dehydrogenase in blood, and $TNF{\alpha}$ was normalized in 8 h after the treatment with $\text\tiny{D}$-GalN/LPS. Coincidently, major organs remained unimpaired when compared to $\text\tiny{D}$-GalN/LPS control group. Moreover, p38, which stimulates expression of NAFLD-associated cytokines, was markedly inhibited when treated with SGBE. In vitro analysis revealed that the main components of SGBE, linoleic acid and ginsenoside Re/Rd, may play a role in protecting liver from $\text\tiny{D}$-GalN/LPS-induced toxicity. Finally, we concluded that SGBE may be a promising therapeutic agent for preventing damage to the liver.

[ $^1H$ ] MR Spectroscopy of the Normal Human Brains: Comparison between Signa and Echospeed 1.5 T System (정상 뇌의 수소 자기공명분광 소견: 1.5 T Signa와 Echospeed 자기공명영상기기에서의 비교)

  • Kang Young Hye;Lee Yoon Mi;Park Sun Won;Suh Chang Hae;Lim Myung Kwan
    • Investigative Magnetic Resonance Imaging
    • /
    • v.8 no.2
    • /
    • pp.79-85
    • /
    • 2004
  • Purpose : To evaluate the usefulness and reproducibility of $^1H$ MRS in different 1.5 T MR machines with different coils to compare the SNR, scan time and the spectral patterns in different brain regions in normal volunteers. Materials and Methods : Localized $^1H$ MR spectroscopy ($^1H$ MRS) was performed in a total of 10 normal volunteers (age; 20-45 years) with spectral parameters adjusted by the autoprescan routine (PROBE package). In all volunteers, MRS was performed in a three times using conventional MRS (Signa Horizon) with 1 channel coil and upgraded MRS (Echospeed plus with EXCITE) with both 1 channel and 8 channel coil. Using these three different machines and coils, SNRs of the spectra in both phantom and volunteers and (pre)scan time of MRS were compared. Two regions of the human brain (basal ganglia and deep white matter) were examined and relative metabolite ratios (NAA/Cr, Cho/Cr, and mI/Cr ratios) were measured in all volunteers. For all spectra, a STEAM localization sequence with three-pulse CHESS $H_2O$ suppression was used, with the following acquisition parameters: TR=3.0/2.0 sec, TE=30 msec, TM=13.7 msec, SW=2500 Hz, SI=2048 pts, AVG : 64/128, and NEX=2/8 (Signa/Echospeed). Results : The SNR was about over $30\%$ higher in Echospeed machine and time for prescan and scan was almost same in different machines and coils. Reliable spectra were obtained on both MRS systems and there were no significant differences in spectral patterns and relative metabolite ratios in two brain regions (p>0.05). Conclusion : Both conventional and new MRI systems are highly reliable and reproducible for $^1H$ MR spectroscopic examinations in human brains and there are no significant differences in applications for $^1H$ MRS between two different MRI systems.

  • PDF