To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles) but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the f4 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.
Tissue distribution of RHDV in rabbits were examined by immunofluorescence and ABC methods. Tissues including liver, spleen, kidneys, lungs and brain were frozen, cut in a crycut, and fixed in 10% buffered formalin, embedded in paraplast, and cut $5{\sim}7{\mu}m$ thickness. Sections were immunostained Tissue distribution of RHDV in rabbits were examined by immunofluorescence and ABC methods. Tissues including liver, spleen, kidneys, lungs and brain were frozen, cut in a crycut, and fixed in 10% buffered formalin, embedded in paraplast, and cut $5{\sim}7{\mu}m$ thickness. Sections were immunostained with primary antiserum and conjugated second antibodies as recommended by manufacturer. None of the cultures tested showed virus-induced phenomena. Immunoreactive products were commonly found in the liver, in some cases there were also positive staining in the spleen and kidneys. Other organs showed weak or insignificant immunoreactions. By ABC method on the formalin-fixed, paraffin-embedded liver tissues, strong immunoreactivity was found in the periportal triad lesions and peripheral lesions of the hepatic lobules. Immunoreactive products showed diffuse fine granular in the cytoplasm of hepatocytes and sinusoidal cells. In some cells, immunoproducts marginate at the periphery of the cells. The intensive staining of the cytoplasm of infected cells allowed their exact differentiation from surrounding uninfected cells. The positive area involved coincided with histopathological lesion on serial liver sections. In conclusion, liver was proved to be a consistent target organ in RHD, and the immunoperoxidase method in the section of formalin-fixed, paraffin-embedded hepatic tissue could be broadly used for the routine diagnosis of the disease.
A subcapsular liver hematoma (SLH) is a relatively common lesion in fetuses and neonates. Although an SLH ruptures rarely, it may be life threatening. We report on a term neonate with a delayed rupture of an SLH that occurred on day 7 of life. The infant had been resuscitated with intubation, positive pressure ventilation, and chest compression at birth because of meconium-associated perinatal depression. The SLH was diagnosed by abdominal ultrasonography and paracentesis, and the ruptured SLH was treated operatively. After intensive medical and surgical management, the infant was discharged healthy on day 27 of life. A newborn infant presenting with the sudden onset of extreme shock and pallor associated with abdominal distension should undergo differential diagnosis for SLH and a clinical evaluation concurrent with fluid resuscitation and timely surgery.
The fine needle aspiration biopsy(FNAB) has become a popular method to diagnose mass lesions of the liver. Although many reports have listed FNAB criteria to be used to diagnose hepatocellular carcinoma(HCC), a diagnostic dilemma still exists at the extreme ends of the spectrum, particularly for well differentiated HCC. The authors reviewed a series of FNAB specimens of the liver to distinguish well differentiated HCC from nonneoplastic liver. Fifteen cytologic features were examined in this study: high cellularity, large sheet formation, trabecular pattern, acinar pattern, dispersed pattern, irregular arrangement, increased nuclear/cytoplasmic ratio, naked nuclei, irregular chromatin, irregular nuclear contour, multinucleation, uniform macronucleoli, multiple nuclei, uniform small cytoplasm and monotony of atypia. These features were examined in a series of 76 FNAB specimens. Fifty two specimens were from patients with HCC and 24 specimens were from patients with nonneoplastic lesion or tumors other than HCC containg adequate amount of nonneoplastic hepatocytes in smear. All specimens were coded as to the presence or absence of the above cytologic features. With the use of step-wise logistic regression analysis, three features were identified as the key cytologic features predictive of HCC: irregular chromatin, monotony of atypia and absence of large sheet formation. When these criteria were used, the sensitivity diagnosing HCC by FNAB was 94.2%, specificity 100%, positive predictive value 100% and negative predictive value was 88.9%.
An, Su-Jin;Moon, Jong-Hyun;Hwang, Tae-Sung;Lee, Hee-Chun;Yu, Do-Hyeon;Sur, Jung-Hyang;Jung, Dong-In
Journal of Veterinary Clinics
/
v.35
no.4
/
pp.155-160
/
2018
A 6-year-old intact female Shih-tzu dog was referred due to anorexia. Physical examination, complete blood count, serum chemical analysis, radiography, and ultrasonography were evaluated. Physical examination and hematological analysis showed normal findings. Abdominal radiographs and ultrasound revealed well-defined masses in the spleen. Other abdominal organs showed no significant abnormalities. Tissue samples taken via sono-guided fine needle aspiration of the splenic mass showed many bare nuclei, which were variable in size. Results of histopathological and immunohistochemical (IHC) analyses performed after splenectomy were consistent with paraganglioma. Based on these findings, we diagnosed this patient with a paraganglioma of splenic origin. Two months after splenectomy, abdominal ultrasonography revealed a new neoplastic lesion in the liver. The clients refused further management and the patient expired three months after initial diagnosis. Necropsy as well as histopathological and IHC examinations of other systemic organs including the liver, adrenal gland, kidney, brain, urinary bladder, lung, aortic body, carotid body, and pancreas were performed. The neoplastic tissue in the liver also demonstrated features of a paraganglioma, and there were no remarkable findings in all other organs.
Kim, Hyun-Young;Moon, Suk-Bae;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
Advances in pediatric surgery
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v.14
no.2
/
pp.153-163
/
2008
Inflammatory myofibroblastic tumor (IMT) is a rare reactive lesion characterized by the feature of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. Extrapulmonary IMTs in children have been described involving the mesentery, omentum, retroperitoneum, abdominal soft tissues, liver, bladder, mediastinum, head and neck, extremity, appendix, and kidney. Medical records of children treated with abdominal IMT between 1985 and 2005 were reviewed retrospectively. Seven children were treated for IMT with the mean age of 3 y 2 m (range, 1 y 1 m to 14 y). Tumors were located in transverse mesocolon (n=2), omentum (n=1), porta hepatis (n=2), complex site (antrum, duodenum, common bile duct, porta hepatis) (n=2). The symptoms included abdominal mass, fever, jaundice, abdominal pain and anemia. The masses were excised totally in transverse mesocolon, omentum IMT and there is no evidence of recurrence (follow-up periods: 6 y 8 m, 8 y 9 m, 4 y 10 m). In porta hepatis IMT, liver transplantations were performed and there is no evidence of recurrence (follow period: 6 y 8 m, 8 y 7 m). In one case of complex site IMT, partial excision of mass was performed and he still survived with no change of the residual tumor during follow-up period. The other one of complex site IMT denied further treatment after the biopsy. In conclusion, complete surgical excision including liver transplantation and close follow-up are mandatory for the abdominal IMT in child.
Jong Deok Lee;Jeong Min Lee;Sang Won Kim;Chong Soo Kim;Woo Sung Mun
Korean Journal of Radiology
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v.2
no.3
/
pp.151-158
/
2001
Objective: To determine the ability of MR imaging to detect the pathological changes occurring in radiofrequency (RF) thermal lesions and to assess its accuracy in revealing the extent of tissue necrosis. Materials and Methods: Using an RF electrode, thermal lesions were created in the livers of 18 rabbits. The procedure involved three phases. In the acute phase, six animals were killed the day after performing thermal ablation with RF energy, and two on day 3. In the subacute and chronic phases, eight rabbits underwent percutaneous hepatic RF ablation. After performing MR imaging, two animals were sacrificed at 1, 2, 4, and 7 weeks after the procedure, and MRpathologic correlation was performed. Results: In the acute phase, the thermal ablation lesions appeared at gross examination as well-circumscribed, necrotic areas, representing early change in the coagulative necrosis seen at microscopic examination. They were hypointense on T2-weighted images, and hyperintense on T1-weighted images. Gadolinium-enhanced MR imaging showed that a thin hyperemic rim surrounded the central coagulative necrosis. In the subacute phase, ablated lesions also showed extensive coagulative necrosis and marked inflammation at microscopic examination. Beyond two weeks, the lesions showed gradual resorption of the necrotic area, with a peripheral fibrovascular rim. The size of lesions measured by MR imaging correlated well with the findings at gross pathologic examination. Conclusion: MR imaging effectively demonstrates the histopathological tissue change occurring after thermal ablation, and accurately determines the extent of the target area.
Purpose: To assess the usefulness of breath-hold fast MR imaging of liver with fat suppression (FS) by application of chemical saturation technique in the diagnosis of regional fatty changes suspected in sonography. Materials and Methods: Thirteen patients who had focal lesions with diffuse, homogeneous signal changes after FS through chemical saturation technique without additional changes of imaging parameter during MR imaging of liver were selected. T1-weighted fast low-angle shot and T2-weighted turbo spin-echo sequences were obtained with or without FS during each single breath-holding session. Subjective changes of signal intensity between the pre-FS and the FS images were compared with the sonographic findings in each lesion. Results: Seven lesions of decreased signal intensity after FS on T1 or T2-weighted images, including three lesions only at FS T1 images, were regarded as focal fat infiltration. All seven lesions had compatible sonographic findings as homogenously echogenic areas. Another six lesions of subjectively increased signal intensity including two lesions only at FS T2 images were regarded as focal fat sparing. All six lesions had sonographic findings as homogenous echo poor areas suggesting focal fat sparing. In cases regarded as fat infiltration, score changes were more prominent at FS T1 images than FS T2 images(p=0.0002). In cases regarded as fat sparing, score changes were more prominent at FS T2 images than FS T1 images(p=0.042). Conclusion: Breath-hold fast T1 and T2-weighted MR imaging with and without chemical saturation pre-pulse may be sufficient for characterization of regional fatty changes in the differential diagnosis of focal hepatic lesion found at sonography.
Proceedings of the Korean Society for Food Science of Animal Resources Conference
/
1999.06a
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pp.97-117
/
1999
This study was performed to investigate the effect of pork on the cadmium detoxification in rats. Ninety male Sprague-Dawley rats weighing $125.3{\pm}1.4g$ were divided into five groups based on cadmium treatment(0, 25, 50, 100, 250ppm) and five levels of Cd in AIN-76 purified diet had been fed for 8 weeks. Cadmium was supplemented with a form of $CdCl_2$.. During following 8 weeks of intoxication, casein was replaced by pork and the effect of pork on cadmium- detoxification was compared with casein. After 8 weeks of Cd intake had resulted in apparent cadmium intoxication; reduced growth rate, enlarged kidney and testis, decreased hematocrit value and hemoglobin content in response to the supplemented Cd levels in the diets. Discontinuing cadmium feeding, the body weights were relieved. Pork-fed groups seemed to have higher body weight than casein-fed groups. Hemoglobin content and hematocrit value became normal range at detoxification stage. The weights of liver, kidney, and testis were decreased along with cadmium intake. However, organ weight ratio was not affected by cadmium. Cadmium accumulation in liver and kidney showed a tendency to increase in the cadmium-exposed groups. The levels of metallothionein were also significantly elevated in the tissues of liver in response to the levels of Cd supplemented(p<0.05). Cadmium concentration in kidney was two times higher than that in liver. Cadmium removal rate of liver was higher than that of kidney. Cadmium accumulation of the pork-fed group was lower than that of casein. Especially, the factors which affected the cadmium contents in kidney were $Cd^{***}$ and $Cd{\times}pork^{***}$. Metallothionein(MT) was increased with cadmium, and MT was not likely to be affected by pork. Based on the findings from gross lesion, rats fed 250ppm of Cd were externally emaciated, had exposed penis and observed atrophies of kidney and testis. Histopathological observation seemed that the liver of groups feeding Cd supplemented diets showed cellular degeneration and accumulation of eosinophilic materials in the capillaries. In kidney, rats fed Cd diets had shown tubular epithelium degeneration and lesions of basophilic materials, while testis were weakened in numbers of spermatid and sporadically enlarged of giant cells. But the rats administered cadmium-detoxified diet supplemented pork for 7 weeks were shown individually decreased lesions compared with the rats supplied with casein diet.
Byeong Hak Sim;Suk Hee Heo;Sang Soo Shin;Seong Beom Cho;Yong Yeon Jeong
Journal of the Korean Society of Radiology
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v.81
no.2
/
pp.365-378
/
2020
Purpose This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0-F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.
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