2.Hepatic surgery in the era of liver transplantation.
Chinese Journal of Surgery 2007;45(9):580-583
Humans
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Hypertension, Portal
;
surgery
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Liver
;
pathology
;
surgery
;
Liver Failure
;
surgery
;
Liver Neoplasms
;
surgery
;
Liver Transplantation
3.Infantile hemangioendothelioma of the liver: a case report.
Yeon Lim SUH ; Kyung Ja CHO ; Je G CHI ; Kwi Won PARK
Journal of Korean Medical Science 1987;2(3):195-200
A case of type 1 infantile hemangioendothelioma of the liver in a 3 month old male infant who had an abdominal mass incidentally noted at 40 days of age, is described. Grossly, the tumor showed a well circumscribed, pinkish gray and gelatinous mass with areas of central necrosis, multifocal thrombi and hemorrhages, and small cysts. Microscopically, the lesion consisted of numerous vascular channels of various size lined by a single layer of flat or plump endothelial cells. Areas of infarction, thrombosis and calcification, and formation of cavernous hemangiomatous foci were also noted in the lesion. Ultrastructurally, the cells had the characteristics of endothelium, including basal lamina, pinocytic vesicles, and Weibel-Palade bodies. Factor VIII-associated antigen was demonstrated in the tumor cells.
Hemangioendothelioma/*pathology/surgery
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Humans
;
Infant
;
Liver Neoplasms/*pathology/surgery
;
Male
7.Current status and future perspectives on the methods of prognosis evaluation for intrahepatic cholangiocarcinoma.
Gu Wei JI ; Zheng Gang XU ; Shu Ya CAO ; Ke WANG ; Xue Hao WANG
Chinese Journal of Surgery 2023;61(6):467-473
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary malignant tumor in the liver after hepatocellular carcinoma. Its incidence and mortality rates have increased worldwide in recent years. Surgical resection is the best treatment modality for ICC;however,the overall prognosis remains poor. Accurate evaluation of post operative prognosis allows personalized treatment and improved long-term outcomes of ICC. The American Joint Commission on Cancer TNM staging manual is the basis for the standardized diagnosis and treatment of ICC;however,the contents of stage T and stage N need to be improved. The nomogram model or scoring system established in the analysis of commonly used clinicopathological parameters can provide individualized prognostic evaluation and improve prediction accuracy;however,more studies are needed to validate the results before clinical use. Meanwhile,imaging features exhibit great potential to establish the post operative prognosis evaluation system for ICC. Molecular-based classification provides an accurate guarantee for prognostic assessment as well as selection of populations that are sensitive to targeted therapy or immunotherapy. Therefore,the establishment of a prognosis evaluation system,based on clinical and pathological characteristics and centered on the combination of multidisciplinary and multi-omics,will be conducive to improving the long-term outcomes of ICC after surgical resection in the context of big medical data.
Humans
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Bile Ducts, Intrahepatic/pathology*
;
Cholangiocarcinoma/pathology*
;
Prognosis
;
Liver Neoplasms/surgery*
;
Bile Duct Neoplasms/pathology*
8.Solid mesenchymal hamartoma of the liver in adult.
Jin Haeng CHUNG ; Kyung Ja CHO ; Dong Wook CHOI ; Byung Hee LEE ; Je Geun CHI
Journal of Korean Medical Science 1999;14(3):335-337
This paper presents an unusual solid mesenchymal hamartoma of the liver (MHL) in adult. A well defined solid mass in the left lobe of the liver was found in a 57-year-old female. Preoperative radiologic examinations demonstrated solid mass with multifocal calcifications abutting the gallbladder. By light microscopy, the lesion was composed of dense fibrous stroma with hyalinization, bile ducts and thick-walled vessels without hepatocytes. The solid and hyalinized mesenchymal component would suggest an unusual degenerative change representing a burnt-out MHL.
Case Report
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Female
;
Hamartoma/surgery
;
Hamartoma/radiography
;
Hamartoma/pathology*
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Human
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Liver Neoplasms/surgery
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Liver Neoplasms/radiography
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Liver Neoplasms/pathology*
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Mesoderm/pathology
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Middle Age
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Tomography, X-Ray Computed
9.The pathological feature of primary hepatic carcinoma on explanted liver and its significance.
Tong-Lin ZHANG ; Shao-Hua MA ; Dian-Rong XIU ; Shi-Bing SONG ; Chun-Hui YUAN ; Yi-Mu JIA ; En-Cong GONG
Chinese Journal of Surgery 2010;48(13):964-967
OBJECTIVETo investigate the pathological feature of primary hepatic carcinoma and the clinical significance.
METHODSFrom August 2000 to December 2007, there were 89 patients with cirrhosis and carcinoma of liver who accepted whole liver resection. The whole liver was cut into 10 mm slices to examine the tumor size, number, distribution, capsule, satellite nodes, portal vein tumor thrombi (PVTT). The invaded adjacent tissue and lymph nodes were recorded, the distance from satellite to major tumor was measured, then histological examinations were carried out, and the final diagnosis was made by pathologists.
RESULTSThe total of 89 cases included hepatocellular carcinoma in 86 cases and cholangiocarcinoma in 3 cases; 53 cases with multiple tumors and 36 cases with solitary tumor; complete capsule only in 14 cases, no obvious margin in 11 cases, 13 cases had a major tumor in the right lobe and a small tumor in the left lobe; 8 of 25 cases with gross invaded tissue were confirmed by histological examination, 7 of 16 cases with swollen lymph nodes were infiltrated by cancer cells. There were 47 cases with PVTT (47.2%) and 39 cases with satellite nodes (43.8%). PVTT and satellite nodes increased with the increase of sizes and the numbers of the tumors. The distance from satellite node to major tumor mostly were 0.5 - 3.0 cm.
CONCLUSIONSThe whole explanted liver can completely reflect the characteristics of growth and infiltration of hepatic carcinoma. Attention must be paid to the small cancer lesions in another lobe, distal satellite nodes from major tumor, and tumor thrombi in a small branch of portal vein, which can not be found by imaging, and might influence the curative effectiveness after liver resection or transplantation.
Adult ; Carcinoma, Hepatocellular ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver ; pathology ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Young Adult
10.Association of microvascular invasion with recurrence and prognosis of patients with small hepatocellular carcinoma undergoing liver transplantation.
Yang-Bo ZHU ; ; Xiao XU ; ; Shu-Sen ZHENG ;
Journal of Zhejiang University. Medical sciences 2014;43(6):658-663
OBJECTIVETo evaluate the risk factors for recurrence in patients with hepatocellular carcinoma (HCC) after liver transplantation (LT).
METHODSOne hundred and fifteen small HCC patients, who met Milan criteria (single<5 cm or showing up to three nodules, each of them<3 cm without major vascular invasion or distant metastasis) and underwent LT in our hospital from January 2007 to November 2013, were enrolled in the study. The risk factors for recurrence were analyzed by Cox regression and the influence of the Milan criteria and microvascular invasion (MVI) on the disease-free survival (DFS) and recurrence of patients were assessed with survival analysis and ROC method.
RESULTSNinety-eight out of 115 small HCC patients were included for analysis, the 1-,3-, 5-year overall survival of patients was 91.8%, 80.6%, 79.6% and DFS was 87.8%, 74.5%, 73.5%, respectively. Survival analysis identified that MVI, macro-vascular invasion, exceeding the Milan criteria and pre-transplant down-staging treatment were related to tumor recurrence (P<0.05). Multivariate Cox regression analysis showed that MVI and exceeding the Milan criteria were two independent prognostic indicators for early recurrence of small HCC after LT. The 1-,3-,5-year DFS for 69 patients without MVI and 29 patients with MVI were 92.8%, 85.5%, 85.5% and 75.9%, 55.2%, 48.3%, respectively (P<0.01). The 1-,3-,5-year DFS for 84 patients meeting the Milan criteria and 14 exceeding the Milan criteria were 91.7%, 83.3%, 79.8% and 64.3%, 42.9%, 42.9%, respectively (P<0.01).
CONCLUSIONFor early HCC patients undergoing LT, the presence of MVI would predict tumor recurrence and can be an indicator for the adjuvant treatment or other salvage treatments.
Carcinoma, Hepatocellular ; pathology ; surgery ; Humans ; Liver Neoplasms ; pathology ; surgery ; Liver Transplantation ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; pathology ; Prognosis ; Risk Factors