No abstract available.
Eosinophilia/*pathology ; Humans ; Liver/*pathology ; Liver Abscess/*pathology ; Male ; Middle Aged

Liver abscesses are very rare complications of ulcerative colitis, and furthermore, there has been only one case of splenic abscess in a patient with ulcerative colitis reported in the English literature. We recently encountered a patient with ulcerative colitis accompanied by both hepatic and splenic abscesses. The patient was treated with abscess drainage as well as sulfasalazine and antibiotics. Follow-up sonography of the abdomen showed complete resolution of the lesions. To our knowledge, this is the first report of combined case of multiple liver abscesses combined with splenic abscess in a patient with ulcerative colitis.
Abdominal Abscess/complications/*pathology ; Adolescent ; Colitis, Ulcerative/complications/*pathology ; Female ; Humans ; Liver Abscess/complications/*pathology ; Splenic Diseases/complications/*pathology

Animals ; Bile Duct Diseases ; pathology ; Bile Ducts, Intrahepatic ; pathology ; Cysts ; pathology ; Humans ; Liver Abscess ; pathology ; Liver Diseases ; pathology

Heterogeneous features of liver cancer can mimic liver abscess. Therefore it is essential to double-check tumor markers in the diagnosis of liver abscess. Herein, we report a case of combined hepatocellular-cholangiocarcinoma (cHC) occurred in an unrecognized chronic hepatitis B patient initially misdiagnosed as liver abscess. A 49-year old male initially presented with chill, right upper quadrant pain, and a liver mass. Mass showed peripheral enhancement in arterial phase of computed tomography, which was not typical for hepatocellular carcinoma (HCC). Strikingly elevated alpha-fetoprotein and fine needle aspirated pathology revealed HCC. Despite discordant image findings he was treated with transarterial chemoembolization. He was treated with sorafenib due to metastatic retrocaval lymphadenopathy afterwards. The mass presumed to be HCC progressed with sorafenib. It was surgically resected and he was finally confirmed as cHC. Discordant tumor markers with presumptive image findings should prompt the suspicion of rare type of primary liver cancer, the cHC.
alpha-Fetoproteins ; Biomarkers, Tumor ; Carcinoma, Hepatocellular ; Diagnosis ; Hepatitis B, Chronic ; Humans ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic* ; Liver Neoplasms ; Lymphatic Diseases ; Male ; Needles ; Pathology

Sarcomatoid transformation of intrahepatic cholangiocarcinoma is rarely found but usually has very poor prognosis due to the lack of effective approaches for early detection and its aggressive nature. We report a case of this tumor type, in a 60-year-old man who was referred to our hospital for further evaluation of screening-detected, asymptomatic hepatic lesion. Clinical diagnosis was elusive despite performance of different imaging modalities and a transcutaneous liver biopsy. Pathology of the surgically resected tumor demonstrated intrahepatic sarcomatoid cholangiocarcinoma. In our case, tumor cells expressed strong immunoreactivity to both cytokeratin-19 and vimentin. We assume the relatively good prognosis of this patient would be expected because surgery played a critical role at an early stage of the tumor.
Biopsy ; Cholangiocarcinoma* ; Diagnosis ; Humans ; Keratin-19 ; Keratins ; Liver Abscess* ; Liver* ; Middle Aged ; Pathology ; Prognosis ; Vimentin

PURPOSE: To evaluate whether the presence of a peripheral echogenic rim surrounding internal low echogenicityis helpful in the diagnosis of atypical hepatic hemangioma. MATERIALS AND METHODS: Within a two-year period, aretrospective review of the sonographic appearances of 24 atypical hemangiomas in 21 patients was performed. Diagnosis was made by dynamic and delayed enhanced CT, MR imaging or clinical follow up for one year, including follow-up sonogram. The sonographic appearances of these hemangiomas were analyzed for pattern and thickness ofthe echogenic rim, internal echo pattern, shape, and size. Additionally, forty six lesions of hepatoma, metastasis, abscess and intrahepatic cholangiocarcinoma confirmed by pathology within the same period were also evaluated for the presence of echogenic rim. RESULTS: Twenty-three of 24 lesions showed an echogenic rim ; these were thick in nine cases, and thin in 14 cases. The thickness of the rim was either uniform(n=10) or eccentric(n=13). The average maximum diameter of atypical hemangioma was 4.4cm (range of diameters, 1.5-12cm). The internal echo pattern was partially or entirely hypoechoic in 15 lesions, homogeneously isoechoic in three, and mixed insix cases. Twenty-one lesions were round, and the shape of three was irregular. The other forty six masses including hepatocellular carcinoma, metastases, cholangiocarcinoma and hepatic abscesses did not show an echogenicrim. CONCLUSIONS: The presence of a sonographic echogenic rim in a hepatic mass may help in the diagnosis ofhepatic hemangioma.
Abscess ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Diagnosis ; Follow-Up Studies ; Hemangioma* ; Humans ; Liver Abscess ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pathology ; Ultrasonography*

Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultrasonography-guided aspiration and biopsy suggested an adenocarcinoma with abscess in the liver. At laparotomy, the tumor occupied the left lobe of the liver and invaded the right diaphragm. An extended left lobectomy and a partial excision of the involved diaphragm were done. Grossly, the tumor was 6x5x5 cm in size and had an eccentric necrosis. Microscopically, the tumor was composed of adenocarcinoma and squamous cell carcinoma with a transitional area.
Carcinoma, Adenosquamous/*complications/pathology/surgery ; Case Report ; Human ; Liver Abscess/*etiology ; Liver Neoplasms/*complications/pathology/surgery ; Male ; Middle Age

Hepatocellular calcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer-related deaths worldwide. It is important to diagnose HCC exactly before management is attempted. But, the clinical presentations and radiologic findings of liver abscess, HCC, and metastatic tumor to the liver may be quite similar, and procedures such as serum tumor marker assay, computerized tomography, and ultrasonography of the liver cannot make a specific diagnosis. We report a case of HCC successfully diagnosed by surgery which was misconceived as liver abscess and not improved by medical treatment.
Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Humans ; Liver/ultrasonography ; Liver Abscess/complications/*diagnosis/pathology ; Liver Neoplasms/complications/*diagnosis/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

Non-typhoidal salmonellosis, which is increasing nowadays in Korea as well as in the developed countries, is manifested as enteritis in most cases, but it also encompasses bacteremia, intraabdominal infections, and bone, joint and soft tissue infections. These rare diseases are known to result from primary gastrointestinal infection and subsequent bacteremia with or without symptoms. We experienced a case of neck abscess caused by Salmonella serotype D, which is a rare but important differential diagnosis of neck abscess. We herein report it.
Abscess/*diagnosis/*microbiology ; Aged ; Female ; Humans ; *Liver Cirrhosis ; Neck/*microbiology/*pathology ; Salmonella/*physiology ; Salmonella Infections/*complications

BACKGROUND/AIMS: With the advance of antibiotics and the development of newer imaging techniques, marked changes in etiology, diagnosis, treatment and prognosis of liver abscess have been reported. METHODS: We reviewed the clinical data related to 94 patients with pyogenic liver abscess. RESULTS: Of the 94 patients in the study group, the male to female ratio was 1.4:1 and the peak incidence of liver abcess was in the 7th decade. About three quaters (74.5%) of the abcesses were of unknown origin. The predominant location was in the right lobe (70.3%). Single lesion was found in 80 patients and multiple lesions in 14 patients. Pathogens were identified in 67 patients, of which Klebsiella pneumoniae (65.7%) and E. coli (16.4%) were the most common. The modalities of treatment were percutaneous drainage with antibiotics (73.4%), percutaneous aspiration with antibiotics (16.0%), or antibiotics alone (8.5%). The case fatality rate, mainly from associated underlying diseases, was 9 cases (9.6%). Associated diseases were diabetes mellitus (14.9%) and malignancy (10.6%). CONCLUSIONS: Our study revealed that the most common organism was Klebsiella pneumoniae and percutaneous needle aspiration and/or catheter drainage were safe and effective treatment modalities for pyogenic liver abscess. Prognosis was determined by the underlying condition.
Adolescent ; Adult ; Child ; English Abstract ; Female ; Humans ; *Liver Abscess, Pyogenic/microbiology/pathology/therapy ; Male ; Middle Aged