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Biomedical subjects

P P Anthony

Publications and source records attributed to P P Anthony.

16 recordsLinked to original sources

Spontaneous rupture of a liver cell adenoma after long term methyltestosterone: report of a case successfully treated by emergency right hepatic lobectomy.

A case of spontaneous rupture of a liver cell adenoma is reported in a female transexual treated with methyltestosterone 150 mg daily for 7 years. Emergency right hepatic lobectomy was performed successfully. Histology showed peliosis hepatis also. Emergency resection of a liver cell adenoma has been reported in a young woman taking oral contraceptives, and an elective resection in another female transexual treated with methyltestosterone. However, to the best of our knowledge this is the first case of emergency resection of a spontaneously ruptured liver cell adenoma in a transexual treated with long term methyltestosterone. Since there are numerous other patients similarly treated, it may be expected that this complication will be seen again.

Adult

The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization.

This memorandum provides guidelines on the definition, nomenclature, and classification of cirrhosis, chronic hepatitis, and hepatic fibrosis. These are considered according to morphological characteristics and aetiology. It is hoped that this system will serve as a standard for diagnostic, research, and epidemiological purposes. The relationship of cirrhosis to liver cell carcinoma is briefly discussed and the possible morphological markers of an increased risk of malignancy are defined.

Chronic Disease

Angiosarcoma of the liver in Great Britain, 1963-73.

Deaths attributed to primary angiosarcoma of the liver (ASL) in Great Britain between 1963-73 were reviewed by submitting available histological material to a panel of histopathologists and by obtaining full occupational and residential histories for the cases agreed as ASL by the panel. On average four recorded cases of ASL occurred a year, but in only one-third of the cases submitted did the panel agree with the original diagnosis. Only one of the agreed cases could be confidently associated with exposure to vinyl chloride.

Adult

A phase II study of adriamycin (NSC 123127) in patients with hepatocellular carcinoma from Zambia and the United States.

Nineteen Zambian and 22 American patients with hepatocellular carcinoma were treated with Adriamycin every three weeks in intravenous doses ranging from 20-75 mg/m2 (depending upon their initial serum bilirubin levels). Four of 16 (25%) "good risk" Zambian and American patients who received 75 mg/m2 had objective responses, while in five additional patients there was evidence of either transient tumor regression or disease stabilization. In contrast three of 25 "poor risk" patients who received 20-60 mg/m2 had objective responses. Even in this latter group, however, transient, objective signs of tumor regression were noted in four patients. The results of the present study confirm previous reports suggesting anti-tumor activity for high doses of Adriamycin in hepatocellular carcinoma. Since those responses seen were generally incomplete and transient, further clinical trials of this agent used in combination or sequentially with other agents are indicated.

Adult

Hepatitis B virus infection and primary hepatocellular carcinoma.

Ninety-three patients with biopsy-proven primary hepatocellular carcinoma (PHC) from Uganda, Zambia, and the United States were examined for serologic evidence of hepatitis B virus (HBV) infection. Patients were tested for hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs), antibody to the hepatitis B core antigen (anti-HBc), hepatitis B e antigen (HBeAg), and its antibody (anti-HBe). Active HBV infection, as indicated by positive tests for HBsAg (with or without anti-HBs) and anti-HBc (without anti-HBs), was present in 62% of PHC patients (58 of 93), in contrast with 10% of African controls (9 of 90), and less than 1% of most United States adult populations reported in the literature. The presence of HBeAg or anti-HBe was rare among PHC patients and controls.

Adolescent

Primary carcinoma of the liver.

Primary carcinoma of the liver is rare in Western countries but it is a common malignant tumour in many parts of the tropics. Much has been learnt in recent years about its pathology, manifestations, and aetiology that is relevant to the whole field of oncology. The important distinction between carcinomas of liver-cell and bile-duct origin, the phenomenon of alpha-fetoprotein production, and the role of cirrhosis are discussed in the context of newly discovered aetiological factors such as gonadal steroids, mycotoxins, and the hepatitis B virus.

Adenoma, Bile Duct

Precursor lesions for liver cancer in humans.

Our knowledge of the cellular changes that lead to liver cell carcinoma in humans is limited by proper and necessary ethical restriction on clinical research. We know rather more about risk factors, the most important of which is cirrhosis, it seems that both the causative agent and the time of duration of the cirrhotic process are relevent to the magnitude of this risk. According to present knowledge, alpha1-antitrypsin deficiency, alcoholism, naturally occurring carcinogens, drugs, and the hepatitis B virus seem to carry the greatest risk of cancer developing in a cirrhotic patient. Cirrhosis, however, is not an essential prerequisite, and some or possibly all of these agents can also induce cancer without cirrhosis. Bile duct carcinoma commonly follows infestation with liver flukes. Cirrhosis is usually absent but duct epithelial hyperplasia is present prior to the development of cancer. Many cellular changes have been observed in patients and among populations considered to be at risk from liver cancer. Of these, liver cell dysplasia is the most striking and studies of its prevalence, natural history, and association with cirrhosis suggest that it is a precancerous change.

Africa

A staging system for hepatocellular carcinoma: prognostic factors in Ugandan patients.

A staging scheme for hepatocellular carcinoma was presented at an International Symposium on Liver Cancer in Kampala, Uganda in 1971. Historical, clinical, and laboratory aspects of that staging scheme were examined for prognostic significance in 72 untreated patients with this disease studied at the Uganda Cancer Institute. The median survival for the entire group was 1 month. The presence of a serum bilirubin concentration of greater than 2 mg/100 ml or weight loss greater than 25 percent of body weight were the poorest prognostic features. Other factors with prognostic significance were visible abdominal collateral circulation, ascites, tumor differentiation, and serum levels of alkaline phosphatase, SGOT, alpha fetoprotein, and proline hydroxylase. A modified staging scheme is presented which defines three prognostically different groups of Ugandan patients. It is hoped this staging scheme will serve as a stimulus for analysis of similar prognostic features in other populations of patients with hepatocellular carcinoma.

Adult

Adenoid cystic carcinoma of the breast: prevalence, diagnostic criteria, and histogenesis.

Three cases of adenoid cystic carcinoma have been identified in a 10-year review of 2686 cases of breast carcinoma. The criteria necessary for diagnosis have been reviewed with particular reference to cribriform intraduct carcinoma and adenocarcinoma of the breast with small, dark, 'basaloid'-cell pattern. The most important single diagnostic criterion of adenoid cystic carcinoma is a biphasic cellular pattern which may be aded by the demonstration of two types of mucin stromal acid mucopolysaccharide and ductal neutral mucopolysaccharide. This tumour most frequently presents as a painful or tender mass near the areola, and it carries a uniquely favourable prognosis when compared with similar tumours elsewhere in the body. Actomyosin has been demonstrated in all three tumours by an immunofluorescent method, and this supports a predominantly myoepithelial origin.

Actomyosin

Precancerous changes in the human liver.

Knowledge of the cellular changes that lead to hepatic neoplasia in humans is limited. Cirrhosis is a common antecedent or accompaniment of liver cell carcinoma and it seems that both its etiology and its time of duration are relevant risk factors. Many cellular changes have been observed in patients and among populations considered to be at risk. Of these, liver cell dysplasia is the most striking, and studies of its prevalence, natural history, and association with particular forms of cirrhosis suggest that it is a precancerous change. Bile duct carcinoma may follow infestation with liver flukes and duct epithelial hyperplasia is present before the development of cancer. Angiosarcoma from several causes is commonly preceded by a peculiar fibrosis, vascular changes, and Kupffer cell hyperplasia.

Aged