Pedunculated hepatocellular carcinoma was first described by Roux in 1987, and Goldberg and Wallerstein presented a case with pathological description in 1934. Since then 37 cases have been reported in the world literature. A pedunculated hepatocellular carcinoma, occurred in a 69-year-old woman, was encountered. It was attached to the Glission's capsule of the right lobe of liver inferiorly, and was connected to the porta hepatis bt a mesenteric pedicle containing arteries, veins, bile ducts and nerve bundles. The tumor mass was completely encapsulated, and measured 8.5x8x6 cm and 255 gm. It was composed of hepatocellular carcinoma of a well-differentiated, acinar type. Tumor cells were positive for HBsAg, but negative for alpha-fetoprotein on peroxidase-antiperoxidase staining. The liver exhibited macronodular cirrhosis on gross examination. This tumor is thought to have on in the supernumerary lobe of liver.
Female ; Humans ; Carcinoma, Hepatocellular

We performed IV bolus CT scan in 40 patients with final diagnosis of various hepatic masses in order to evaluate hemodynamic changes and differentiating characters of the lesions. Preenhanced, early and late phase post enhanced, and delayed CT scans were obtained with rapid IV bolus injection of contrast materials and table sliding method for pertinent scans. In hepatomas, early enhanced CT scan directly showed hypervascular change and active viable portion of the mass and late phase CT scan showed capsular enhancement. In addition, extracapsular invasion and post-embolization recurrence were more easily visualized. In hemangiomas, early and late enhancing types could be categorized according to the time of maximal enhancement. In metastatic liver malignancies and cholangiocarcinomas, specific findings were seen in early phase and delayed CT scans and not in conventional CT scan. In conclusion, IV bolus CT scan is a very useful CT method in demonstrating the characteristic hemodynamic patterns and in differential diagnosis of the hepatic masses.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Liver ; Methods ; Recurrence ; Tomography, X-Ray Computed*

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

Isolated heaptic tuberculous granuloma with no coexistent tuberculosis elsewhere in the body is extremely rare. We report a case of pathologically proven tuberculous granuloma in the liver followed with both IV bolus and portal CT scans. The lesion on preenhanced CT scan showed undefinable isodensity. After IV bolus injection, it showed poor enhancement with central low-density and surrounding hyperdenity due to compensatory hypervascularity of the left lobe of liver in early phase. It showed peripheral rim enhancement in late phase and in delayed phase showed relatively homogeneous but slightly decreased contract enhancement. On portal CT scan, it showed a hypodense portal defect similar to other hepatic mass lesions. During follow-up studies, it was a slowly growing mass which was more easily detectable by prtal CT scans than bolus CT scans.
Follow-Up Studies ; Granuloma* ; Liver ; Tomography, X-Ray Computed ; Tuberculosis

The primary malignant melanoma arising in the leptomeninges of the central nervous system is extremely rare. We report a case of malignant melanoma, apparently thought to be originated from leptomeninges, with diffuse neoplastic process widely spreaded over the leptomeninges of 42 years old man, who had suffered severe headache, nausea and left hemiparesis. This patient is free of the symptoms for six months after operation. The literature on this subject is briefly reviewed.
Adult ; Central Nervous System ; Headache ; Humans ; Melanoma* ; Nausea ; Paresis

A case of fibroepithelial polyp with stromal atypia in a 25-year-old female is described. The tumor arose from the vaginal wall and measured 3.5 cm in maximal diameter. It was composed of hypercellular connective tissue stroma and focal myxoid area containing numerous atypical mono- and multinucleated stromal cells. These cells may mislead to make a diagnosis of sarcoma, particulary of botryoid rhabdomyosarcoma.
Adult ; Connective Tissue ; Diagnosis ; Female ; Humans ; Polyps* ; Rhabdomyosarcoma ; Sarcoma ; Stromal Cells* ; Vagina*

For the elucidation of a possible pathogenetic mechanism of fatty accumulation by the orotic acid in the liver, male Sprague-Dawley rats were fed on semisynthetic diet containing 1 per cent orotic for a week, and followed by the morphological examination on the rat livers. The experimental animals were sacrificed on the 1st, 2nd, 3rd, and the 7th days of orotic acid feeding and daily sacrifice was performed after conversion to normal diet feeding during the performed after conversion to normal diet feeding during the period of successive 7 days. The control group animals were fed on normal regular diet, or semisynthetic diet without orotic acid. The liver tissues were examined by the light ad electron microscopy, together with electron microscopic cytochemical study for glucose-6-phosphatase and thiamine pyrophosphatase. On the light microscopy, the lipid droplets began to appear in the 3rd day of orotic acid feeding and then occupy through the all hepatic lobules in the 7th day of orotic acid feeding. On the electron microscopy in the 3rd day of orotic acid administraion, the endoplasmic rdticulum were fragmented and vesiculated, and vesicles containing VLDL particles were demonstrated closely around the Golgi complex. In the 7th day, Golgi complex were increased in numbers. The limiting membrances of lipid vacuoles were regarded to originated from rough-surfaced endoplasmic reticulum of account of demonstration of glucose-6-phospatase in them. In the Golgi complex the activity of thyamine pyprophosphatase were markedly decreased in the 1st day of orotic acid feeding, and then the activity of this enzyme is failed to present afterthat. On the above findings it is assumed that orotic acid depresses the function of trans aspect of Golgi stack and the VLDL is interrupted and followed by the retrograde accumulation of VLDL. The cis aspect of Golgi stack and rough-surfaced endoplasmic reticulum were accumulated with VLDL particles, and eventually coalesced vesicles of VLDL with become lipid vacuole. The sequential alteration of endoplasmic reticulum and Golgi complex is supporting the concept of conformational change of membranes in cytocavitary net-work.
Male ; Humans ; Rats ; Animals

For the elucidation of a possible pathogenetic mechanism of fatty accumulation by the orotic acid in the liver, male Sprague-Dawley rats were fed on semisynthetic diet containing 1 per cent orotic for a week, and followed by the morphological examination on the rat livers. The experimental animals were sacrificed on the 1st, 2nd, 3rd, and the 7th days of orotic acid feeding and daily sacrifice was performed after conversion to normal diet feeding during the performed after conversion to normal diet feeding during the period of successive 7 days. The control group animals were fed on normal regular diet, or semisynthetic diet without orotic acid. The liver tissues were examined by the light ad electron microscopy, together with electron microscopic cytochemical study for glucose-6-phosphatase and thiamine pyrophosphatase. On the light microscopy, the lipid droplets began to appear in the 3rd day of orotic acid feeding and then occupy through the all hepatic lobules in the 7th day of orotic acid feeding. On the electron microscopy in the 3rd day of orotic acid administraion, the endoplasmic rdticulum were fragmented and vesiculated, and vesicles containing VLDL particles were demonstrated closely around the Golgi complex. In the 7th day, Golgi complex were increased in numbers. The limiting membrances of lipid vacuoles were regarded to originated from rough-surfaced endoplasmic reticulum of account of demonstration of glucose-6-phospatase in them. In the Golgi complex the activity of thyamine pyprophosphatase were markedly decreased in the 1st day of orotic acid feeding, and then the activity of this enzyme is failed to present afterthat. On the above findings it is assumed that orotic acid depresses the function of trans aspect of Golgi stack and the VLDL is interrupted and followed by the retrograde accumulation of VLDL. The cis aspect of Golgi stack and rough-surfaced endoplasmic reticulum were accumulated with VLDL particles, and eventually coalesced vesicles of VLDL with become lipid vacuole. The sequential alteration of endoplasmic reticulum and Golgi complex is supporting the concept of conformational change of membranes in cytocavitary net-work.
Male ; Humans ; Rats ; Animals

A study on branching patterns of middle hepatic artery was performed in 109 patients with A-P and oblique view hepatic angiogram, which refered to size and location of quadrate lobe in CT and SMA portography We could analyze the branching patterns of middle hepatic artery (MHA) in 100 among the 109 patients. MHA arising as a first branch of left hepatic artery was the most common pattern (50%), and MHA arising from proper hepatic artery separately one from left hepatic artery was the next common pattern (35%). MHA originating from left gastric artery, or from anterior or posterior of the right hepatic artery was seen. MHA WAS not found as an accessory or replaced artery except as replaced common hepatic artery.
Angiography* ; Arteries ; Hepatic Artery* ; Humans ; Portography