Diagnosis Of Benign Liver Tumors Research Articles

КЛИНИЧЕСКАЯ МОРФОЛОГИЯ ПЕЧЕНИ: ДОБРОКАЧЕСТВЕННЫЕ ОПУХОЛИ

Background. Early diagnosis of benign liver tumors (BLT) is based on the use of methods for visualization of focal lesions of the liver. The final diagnosis of BLT is established using a comprehensive diagnosis, which includes a morphological study. The goal is to present the morphological characteristics of the BLT diagnosed in the Grodno region. Material and methods. The object of the study was liver biopsy sample obtained by performing aspiration liver biopsy in patients with focal liver disease, liver fragments excised during surgery, and also sectional material. Results. A detailed description of the morphological signs of the most frequently occurring focal lesions of the liver, referred to the BLT, is presented. Among the main BLT are tumors of epithelial and mesenchymal origin: hepatocellular adenoma, adenoma of the intrahepatic bile ducts, cystadenoma of the intrahepatic bile ducts, focal nodular hyperplasia, mesenchymal hamartoma, infantile hemangiendothelioma, hemangioma, adenomatous hyperplasia, liver damage by hematopoietic and lymphoid tissue, cysts, polycystic liver are different. Conclusion. For their morphological features BLT are different from malignant. However, under certain conditions, some BLT can increase to critical sizes, disrupt liver function, lead to complications in the form of internal bleeding and other negative consequences. The most unfavorable outcome of a number of BLT is their malignancy, which requires continuous monitoring of focal liver lesions by visualization methods, the study of molecular-genetic markers of early malignancy, and the use of morphological study of BLT (according to indications).

National trends in the use of surgery for benign hepatic tumors in the United States

The widespread use of diagnostic imaging has led to an increase in the incidence and diagnosis of benign liver tumors. The objective of this study was to define the overall use and temporal trends of operative procedures for benign liver tumors using a nationally representative cohort. All patients who underwent liver surgery for benign liver tumors between 2000 and 2011 were identified from the Nationwide Inpatient Sample database. Trends in annual volume of liver procedures were analyzed using the average annual percent change (AAPC) assessed by joinpoint analysis. There were 2,489 open (94.5%) and 144 (5.5%) minimally invasive surgical (MIS) procedures. Partial hepatectomy accounted for 43.8% of all cases (n = 1,153). Surgery for patients with benign liver tumors increased from 156 in 2000 to 272 in 2011 (AAPC, 5.8%; 95% CI, 3.2-8.6%). There was decline in the relative use of open operative procedures from 98.1% in 2000 to 92.3% in 2011 (AAPC, -0.4%; 95% CI, -0.7 to -0.1%). In contrast, the proportion of MIS procedures increased from 1.9% in 2000 to 7.7% in 2011 (AAPC, 7.4%; 95% CI, 1.9-13.3%). The median duration of stay among all patients was 5 days (interquartile range, 4-7; 5 days [open] vs 3 days [MIS]; P < .001). Inpatient mortality was 0.6% (n = 15 [open] vs n = 0 [MIS]; P = .43) and did not change during the study period (P > .05). Overall volume of surgical management of benign liver tumors has increased substantially over the past decade. There has been a relative shift away from open procedures toward MIS procedures.

Diagnosis and differential diagnosis of benign liver tumors and tumor-like lesions

Benign liver tumors and tumor-like lesions cover a broad spectrum of differential diagnoses, varying from dysontogenetic cysts to pseudolesions. Focal nodular hyperplasia, adenoma and regenerating nodules play a major role in clinical practice. Based on imaging findings, these lesions can be classified as cystic or solid, solitary or multiple, and hyper- or hypovascular. Haemangioma, FNH, steroid-associated adenoma, cystadenoma and echinococcus cysts can be reliably diagnosed using imaging techniques. The same is true for pseudolesions, which are found in particular on dynamic computed tomography. Other entities such as adenoma in cirrhotic livers, angiomyolipoma, regenerating nodules or Echinococcus alveolaris cannot be safely diagnosed by imaging and require biopsy. Morphological and functional characteristics of the most common lesions in the different imaging modalities will be discussed. Where possible, a diagnostic strategy will be presented.