G Benelli — Page 2 | PubMed Health

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[Bone metastasis of hepatocarcinoma. Review of the literature, radiologic pictures and personal caseload].

Prognosis of patients affected with hepatocellular carcinoma (HCC) has been improved by the modern imaging techniques allowing an early diagnosis and by the value of the therapeutic protocols employed. Staging has also become more and more important. Bone metastases from HCC are reportedly rare. The authors observed a 5.5% incidence in 90 cases of hepatocarcinoma. The metastases were demonstrated by radiography, CT, and nuclear scintigraphy, in patients with skeletal pain. The plain film appearance of skeletal metastases from HCC was osteolytic in all cases; no surrounding sclerosis was seen. CT scans demonstrated the destructive nature of these lesions, which were associated with bulky soft-tissue masses. Metastases exhibited increased radiotracer (99mTc-MDP) uptake at bone scintigraphy. The authors believe that bone scintigraphy should be included in the staging protocols of the HCCs which need a potentially curative therapy.

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PubMedDate not supplied

[Ultrasound-guided percutaneous needle biopsy in hepatic lesions suspected of hepatocarcinoma. Evaluation of 104 patients].

The use of US in both everyday routine and regular follow-up of patients affected with chronic hepatopathies makes it possible to detect even very small focal liver lesions. However, in many cases, neither US nor any other imaging method is sufficient for tissue characterization, and biopsy becomes thus indispensable to establish the diagnosis of hepatocellular carcinoma (HCC). The authors report the results of the US-guided biopsies with fine aspirating and cutting needles (FNAB) performed in 104 patients affected with focal liver lesions suspected for HCC. Smear cytology detected 67/83 proven HCCs: in 4 patients it showed a kind of malignancy which could not be typified; the patterns suggestive of HCC were 2, the false negatives were 7 and the inadequates 3. Microhistology, which was performed in 81 patients, allowed HCC to be diagnosed in 56 cases; a diagnosis of generic malignancy was made in 2 patients. There were 9 true negatives, 6 false negative, and 8 inadequates. Thanks to the combination of the two methods, 77 HCCs were diagnosed, with 92.8% typyfying accuracy; the false negatives were 4 and the inadequates 2. Typifying accuracy reached 95.8% in the group of 72 patients, all affected with HCC, in which both investigations were performed; there were 2 false negatives and 1 inadequate. These results confirm the value of US-guided FNAB in the diagnosis of HCC and the complementary role of smear cytology and microhistology: the combined use of the latter methods allows both false-negative and inadequate findings to be markedly reduced.

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