2091/2500. Ciliated hepatic foregut cysts: US, CT, and contrast-enhanced MR imaging. Hepatic foregut cysts are uncommon lesions of the liver. In this report we prospectively examined two patients by means of computed tomography (CT), ultrasound, and contrast-enhanced magnetic resonance imaging. Ciliated hepatic foregut cysts were subsequently demonstrated in both patients following CT-guided biopsy. magnetic resonance imaging was found to be useful in differentiating these cysts from other lesions. ( info) |
2092/2500. Diagnostic pitfall; interpretation of CA 19-9 concentrations in the presence of hepatic dysfunction. A 50 year old man is described with hepatic dysfunction and chronic pancreatitis in whom greatly increased concentrations of the pancreatic tumour marker CA 19-9 combined with an abnormal appearance at endoscopic retrograde cholangiopancreatography lead to the false suspicion of pancreatic carcinoma. CA 19-9 concentrations should be interpreted with caution in patients with intrinsic liver disease or biliary obstruction. ( info) |
2093/2500. Elevated growth hormone levels in patients with non-alcoholic chronic liver disease. High serum concentrations of growth hormone (GH) were found in five patients with chronic liver diseases, including auto-immune chronic active hepatitis (two cases), budd-chiari syndrome, primary biliary cirrhosis and hepatitis b virus associated cirrhosis. Mean levels of GH were 27.8 units (normal up to 5). In three patients elevated prolactin levels were also found (mean 37.3 units for two females, normal up to 20), and 36 units in one male (normal up to 9). No other endocrine disorders were found. Although the association of raised GH levels in patients with alcoholic cirrhosis is well known, its occurrence in patients with non-alcoholic chronic liver disease is not fully established. We describe the effect of the disease course, and steroid treatment on GH levels in one patient with auto-immune chronic active hepatitis, and propose possible mechanisms for this elevation. ( info) |
2094/2500. Hepatic bacillary angiomatosis in a patient with AIDS. We report a case of bacillary angiomatosis involving the liver in addition to multiple cutaneous sites in a patient with AIDS. Abdominal CT demonstrated multiple, small low-attenuation lesions throughout the hepatic parenchyma. Consideration of this entity in the proper clinical setting is essential since it is a readily treatable infection. ( info) |
2095/2500. Liver sarcoidosis showing low-density intrahepatic septa on postcontrast computed tomography. The authors present a patient with massive liver sarcoidosis, showing only slight hepatomegaly on precontrast computed tomogram and multiple low-density intrahepatic septa on postcontrast computed tomogram. sarcoidosis frequently involves the liver, but rarely shows abnormal findings other than hepatomegaly on computed tomograms. Only a few cases have demonstrated a low density intrahepatic area on computed tomograms. In this report, we present a patient with massive liver and pulmonary sarcoidosis, showing low density intrahepatic septa and pulmonary fibrosis on computed tomograms. ( info) |
| alpha 1-antichymotrypsin (alpha 1-ACT) is a serine proteinase inhibitor (serpin) with cathepsin g, mast cell chymase and chymotrypsin as target enzymes. We present the case of a middle-aged man with low plasma levels of alpha 1-ACT, asthma with progression to emphysema, and chronic HCV positive liver disease with selective accumulation of alpha 1-ACT in hepatocytes. This secretory defect is analogous to that seen in Pi Z alpha 1-antitrypsin deficiency. The molecular basis of alpha 1-ACT deficiency in this patient has been characterized by direct sequencing of the alpha 1-ACT genes from the patient and his father. A C-->G transversion in exon III causing a 229Pro-->Ala substitution is proposed to cause a conformational change resulting in abnormal transport through the RER. This mutation was found in one of 20 additional tested patients with chronic obstructive lung disease, but in no control. Two additional polymorphisms of the gene have been identified in unrelated healthy individuals with normal plasma alpha 1-ACT levels. The alpha 1-ACT deficiency state may predispose to obstructive lung disease and influence the course of liver disease. Identification of a specific mutation allows identification of heterozygotes for this deficiency allowing future evaluation of its clinical significance. ( info) |
2097/2500. Hepatic granuloma with progressive calcification: CT appearance. Calcification in the liver is uncommon but not rare in clinical practice, and may be caused by many pathological conditions. We report a patient with hepatic mass on abdominal sonogram and CT scan. The mass was shown as a hypoechoic lesion on abdominal sonogram and as a well-marginated hypodense mass on pre- and postcontrast CT. Inflammatory granuloma was diagnosed by pathological examination following percutaneous needle biopsy. A follow-up precontrast CT scan was performed 22 months after the initial examination, and the hepatic granuloma could be the cause of hepatic parenchymal calcification. ( info) |
2098/2500. Case report: simple liver cyst masquerading as a gastric leiomyoma--a diagnostic pitfall. A 47-year-old woman presented with abdominal pain. A barium meal and CT scan suggested a gastric leiomyoma. Follow-up CT showed that a cyst of the left lobe of the liver was responsible for the appearances. The differential diagnosis is discussed. ( info) |
2099/2500. cyclophosphamide-induced hepatotoxicity in a patient with Wegener's granulomatosis. cyclophosphamide is widely used in the treatment of many vasculitides. Hepatotoxicity associated with such therapy is uncommon but possible. Herein we describe a well-substantiated case of cyclophosphamide-induced hepatotoxicity in a patient with Wegener's granulomatosis. physicians should be aware of this potentially serious reaction when cyclophosphamide therapy is initiated. Baseline liver function tests and periodic assessment are recommended during treatment with cyclophosphamide. ( info) |
2100/2500. Extracardiac 'hot' and 'cold' areas on thallium-201 myocardial SPECT imaging. A 72-year-old man underwent Persantine 201Tl myocardial SPECT imaging that showed a transient area of extracardiac radiotracer accumulation inferior to the inferior wall of the left cardiac ventricle, and a persistent, rounded, cold area in the liver. CT of the abdomen confirmed a cystic lesion in the liver corresponding to the cold area, and the transient extracardiac tracer accumulation area corresponded to a large aneurysm of the distal descending thoracic aorta. An extracardiac abnormal area of 201Tl localization, 'hot' or 'cold', should be included for scan interpretation to depict thoracic and/or upper abdominal lesions(s). ( info) |