Tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA) is rarely encountered. We have diagnosed before death and treated a case of hepatocellular carcinoma (HCC) with TT in the IVC and RA, accompanied by a brain metastasis. The image characteristics on computed tomography (CT), magnetic resonance imaging (MRI), and conventional angiography are discussed.

Brain Neoplasms↗

PubMedDate not supplied

Hemodynamics of small hepatocellular carcinomas (5 cm or less in diameter): cases with discrepant findings between dynamic MR images and hepatic arteriograms.

BACKGROUND: The degrees and patterns of contrast enhancement of small hepatocellular carcinomas (HCCs) on dynamic magnetic resonance (MR) images were compared with those on hepatic arteriograms in 61 patients. METHODS: Dynamic MR imaging was performed within 1 week before hepatic angiography prior to treatment, 3-4 weeks after treatment, and then once every 1-3 months if necessary. Hepatic arteriography was carried out with a coaxial microcatheter inserted into the proper hepatic artery or its distal branches. RESULTS: In 58 of 61 cases, the degrees of contrast enhancement of the tumor in dynamic MR imaging were roughly consistent with those in hepatic arteriography before treatment. In the remaining three cases, however, the tumors were depicted as hyperintense in the arterial dominant phase of the dynamic MR imaging, whereas the tumors were not detected by hepatic arteriography. The tumor detectability is 97% by dynamic MR imaging and 92% by hepatic arteriography. Furthermore, when an HCC nodule was not clearly enhanced by hepatic arteriography after treatment, it was possible by dynamic MR imaging to obtain accurate information on whether the HCC nodule had parasitic arteries. CONCLUSIONS: Dynamic MR imaging was superior to hepatic angiography in contrast resolution. It was therefore considered to be useful in assessing the degrees and patterns of contrast enhancement of small HCCs before and after treatment.

Aged↗

PubMedDate not supplied

Lipiodol retention and massive necrosis after lipiodol-chemoembolization of hepatocellular carcinoma: correlation between computed tomography and histopathology.

This retrospective study examined the computed tomography (CT) criteria for judging the effectiveness of transcatheter arterial Lipiodol-chemoembolization (Lp-chemo-TAE) in 35 cases with hepatocellular carcinoma (HCC). Massive necrosis, defined as involving 97% or more of the HCC nodule, was observed in 15 cases after Lp-chemo-TAE, whereas nonmassive necrosis, defined as involving < or = 96% of the HCC nodule, was observed in the remaining 20 cases. In 12 of 15 cases (80%) with massive necrosis, uniform dense retention of Lipiodol (Lp) was observed throughout the HCC nodule on CT images 3-4 weeks after Lp-chemo-TAE as opposed to only one (5%) of 20 cases with nonmassive necrosis (p < 0.01). Eight of nine cases (89%) with massive necrosis had tumor attenuation values of 365 Hounsfield units (HU) or greater on CT images 3-4 weeks after embolization, as opposed to only four (27%) of 15 cases with nonmassive necrosis (p < 0.01). We conclude that the effectiveness of the Lp-chemo-TAE can be judged on CT from the degree and duration of Lp retention in the HCC nodule and the measurement of the attenuation value of the HCC nodule.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Losses of heterozygosity on chromosomes 17p and 9p/18q may play important roles in early and advanced phases of gallbladder carcinogenesis.

PURPOSE: This present study aimed to investigate the genetic changes in gallbladder carcinogenesis. METHODS: Eleven intramucosal gallbladder carcinomas were compared with 31 invasive lesions for loss of heterozygosity (LOH) on chromosomes 5q, 9p, 17p and 18q, frame-shift mutations in a ten-adenine repeat site within the gene encoding the transforming growth factor beta type II receptor (TGFbetaRII) and an eight-guanine repeat site within BAX, and point mutations in codon 12 of Ki-ras. RESULTS: The incidences of LOH in intramucosal and invasive carcinomas were 14% and 17% on 5q, 9% and 52% on 9p, 64% and 65% on 17p, and 13% and 32% on 18q. No frame-shift mutations were found at TGFbetaRII or BAX, and point mutations in codon 12 of Ki-ras were present in only 8% of the samples. Thus, LOH on 17p was by far the most frequent lesion with similar results in both intramucosal and invasive carcinomas. In contrast, the frequency of LOH on 9p and 18q was distinctly higher in invasive lesions. CONCLUSION: The present data suggest that LOH on 17p may play an important role in the evolution of gallbladder carcinoma from a relatively early phase, while LOH on 9p and 18q may play roles in progression.

Adenine↗