[Proceedings: Liver neoplasms explored using echotomography].
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A hepatocellular carcinoma compressing the duodenum and a metastatic liver tumor adherent to the stomach were treated by radiofrequency ablation after a balloon was percutaneously placed between the tumor and the gastrointestinal tract to avoid bowel perforation. Neither tumor showed enhancement on dynamic contrast material-enhanced CT after radiofrequency ablation. There were no complications related to the procedures.
The relationships between the gross appearance, histologic types, and cytochemical characteristics of hepatocellular neoplasms were studied in B6C3F1 mice given the liver carcinogen diethylnitrosamine either alone or followed by the organochlorine pesticides, 4,4'-dichlorodiphenyltrichloroethane, chlordane, or heptachlor as promoting agents. Hepatocellular neoplasms were categorized according to their cytoplasmic staining properties with hematoxylin and eosin. Acidophilic neoplasms more often displayed increased activity of alkaline phosphatase than did basophilic neoplasms. The activities of glucose-6-phosphatase and adenosine triphosphatase were decreased in both acidophilic and basophilic neoplasms. There was no difference in the activities of these enzymes or gamma-glutamyltranspeptidase between adenomas and carcinomas, although most neoplasms did not display gamma-glutamyltranspeptidase. Chlordane or heptachlor exposure increased the alkaline phosphatase activity in neoplastic cells, but not that of other enzymes. The majority of neoplasms displayed a deficiency of iron accumulation. The macroscopic appearance of neoplasms was closely related to their cytoplasmic staining properties and cytochemical characteristics.
An attempt was made to measure blood flow of portal system at various stages of neoplastic changes in the liver, which could be of some prognostic and therapeutic value. In the group of 80 studied persons, 20 patients had hepatic angioma, 6 patients hepatic cancer, 24 patients metastatic cancer affecting to the liver. Control group consisted of 50 healthy volunteers. No disturbances of blood flow in portal system in the group of patients with hepatic angioma were found. In the group with primary hepatic cancer decrease of TAV and TF in portal and splenic veins were noted, especially in 2 cases with numerous changes with relatively big sum of diameters, as compared with control method. In group with metastases of cancer to the liver slight decrease of blood flow in portal and splenic veins was observed as compared to the control group. Decrease in blood flow in the portal system was seen in cases with numerous and relatively big neoplastic focuses in the liver. Blood flow monitoring might be helpful in evaluation of the progress or regression of infiltrative changes in the liver.
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Personal experience of hepatic scintigraphy and laparoscopy in the diagnosis of secondary tumors of the liver is reported. The usefulness of both the techniques, associated, is proved by the small number of cases (2,98%) where metastases remained undiagnosed before surgery. Considering only the results of scanning, a larger number of "false positive" is noted, while those of laparoscopy are more often "false negative".
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