3 research outputs found
Primary Squamous Cell Carcinoma of the Liver: An Uncommon Finding in Contrast-Enhanced Ultrasonography Imaging
Primary squamous cell carcinoma (SCC) of the liver is rare tumor with an unfavorable prognosis. We report a case of advanced primary SCC of the liver arising adjacent to a nonparasitic liver cyst, invading into the right diaphragm and the right lung tissue. Contrast-enhanced ultrasonography (CE-US) demonstrated unique enhancement in the late vascular phase, which was incompatible with those observed in hepatocellular carcinoma, cholangiocellular carcinoma, or metastatic adenocarcinoma. The patient underwent surgical resection of the tumor followed by systemic chemotherapy with 5-fluorouracil (5-FU) and cisplatin (CDDP), while radiation chemotherapy was not applied because of relatively poor performance status. Although postoperative image analysis revealed no recurrence 4 months later, the patient died 13 months after the operation from recurrence. Immunohistological analysis of the resected specimen revealed that this SCC contained many capillary endothelial vessels expressing CD31 or CD34, possibly reflecting the unique imaging pattern in the late vascular phase of CE-US, which has been reported in choangiolocellular carcinoma. In addition, we reviewed which kind of treatment would be suitable for advanced hepatic primary SCC in the literature. From the review, it could be proposed that a combination of radiation therapy, systemic chemotherapy (5-FU and CDDP) and surgical resection, if possible, is appropriate for advanced primary SCC of the liver
A CASE OF ANAPLASTIC CARCINOMA OF THE PANCREATIC HEAD PRODUCING GRANULOCYTE-COLONY STIMULATING FACTOR
Cytoglobin-expressing cells in the splenic cords contribute to splenic fibrosis in cirrhotic patients
Background and Aim. Among several
noninvasive evaluation methods of portal hypertension
(PH), the measurement of spleen stiffness is a reliable
method for predicting esophageal variceal bleeding;
however, the underlying mechanisms for increased
stiffness remain unclear. We attempted to elucidate the
pathological changes to the spleen and the underlying
mechanisms in patients with PH.
Methods. Histological examination was performed
using splenic tissues from 42 patients with PH who
underwent laparoscopic splenectomy, and the results
were compared with those from patients without PH.
Results. In addition to splenic sinus congestion,
diffuse fibrosis was detected in the splenic cords in the
red pulp of patients with PH. The degree of the fibrosis
was well correlated with severity in thrombocytopenia
and splenomegaly. Cells expressing α-smooth muscle
actin dramatically increased in the splenic cord.
Cytoglobin (Cygb) expression was detected in human
splenic cords as reported in animal reticular cells, and
fluorescent double immunostaining revealed that these
cells expressed α-smooth muscle actin in patients with
PH, suggesting transformation of Cygb-expressing cells
to myofibroblastic cells. Expression levels of
nicotinamide adenine dinucleotide phosphate oxidase
(NOX) 2, nitrotyrosine, and transforming growth factor-
β were markedly upregulated in the red pulp of patients
with PH, implying a significant role of oxidative stress
in the mechanism for splenic fibrosis.
Conclusion. Splenic fibrosis progresses along with
advancement of PH. Cygb-expressing cells in the splenic
cord possibly participate in this process through
mechanisms including oxidative stress