Right Lobe Of Liver Research Articles

Malignant Rhabdoid Tumor of the Kidney Presenting as Intraocular Metastasis

A newborn infant presented with intraocular tumor that was clinically diagnosed as retinoblastoma and treated by exenteration of the globe. Within a few weeks however, a large abdominal mass was noted, which was found to involve the left kidney and right lobe of liver. Pathologic evaluation of the intraocular mass as well as fine-needle aspiration biopsy of the abdominal mass revealed features of malignant rhabdoid tumor. To our knowledge this is the first case of malignant rhabdoid tumor of the kidney with such an unusual clinical presentation.

Computed tomography demonstration of portal venous gas after hepatic artery embolization

Hepatic portal venous gas is an entity frequently associated with a sinister outcome in infantile necrotizing enterocolitis, small bowel infarction and intra-abdominal sepsis (Sisley et al, 1987). A recent case report described its occurrence in a patient receiving monoclonal antibody therapy (Waymack et al, 1987). We describe a case in which portal venous gas appeared secondary to therapeutic embolization of the hepatic artery, a phenomenon which, to our knowledge, has not been reported previously. The diagnosis was made by computed tomography (CT) and the gas remained in the portal system for at least 8 days. A 22-year-old male patient was referred from another hospital following a road traffic accident 2 weeks previously. Laparotomy immediately after the accident had revealed two deep lacerations in the right lobe of liver which were controlled by suturing and drainage. Post-operatively the patient had a persistent pyrexia followed 2 weeks later by melaena and haematemesis associated with hypotension and right hypochondrial pain.

A CASE OF INFLAMMATORY PSEUDOTUMOR OF THE LIVER

Recently we experienced a case of inflammatory pseudotumor (IPT) localizing at a posterior lower region of the right lobe of liver. The case was a 42-year-old female, who come to our hospital with a mild fever and right hypochondriac pain. Hypochondriac tenderness and an increase in WBC were observed, and the patient was admitted. Abdominal echography and CT revealed an about 4cm irregular and localized tumor at a posterior lower region of the right lobe. Abdominal angiograhy showed an occupational lesion at the same region which slightly pressed and excluded the surrounding vessels. A hepatic tumor was suspected and excision of te lesion was carried out. Excised tumor was a yellowish-white solid tumor with clear border accompanied by no pus. It was considered an inflammatory tumor. Pathohistologically features of IPT including severe chronic inflammatory cell invasion and strong fibrogenesis were shown. IPT of the liver is so rare that only 23 cases were reported in Japan.The average age of them was 46.5 years, and the disease was slightly predominant in males. Though the lesions often accompanied by inflammatory findings, the majority were operated on as malignant tumors. No certain tendecy in tumor-arising region was noted.

A CASE OF HEPATOCELLULAR CARCINOMA WITH ADRENAL METASTASIS

The authers report a case of hepatocellular carcinoma with hematogenic metastasis to the adrenal gland together with a review of the literature. A 53-year-old man with the chief complaints of lumbago, dorsalgia, and anorexia was pointed out to have a tumor in the right upper abdomen at a near practitioner, and was admitted to our hospital. On admission no tumor was palpated in the abdomen. Impaired liver function, α-fetoprotein level of 529.5ng/ml, and a slightly elevated noradrenaline were shown. Abdominal computed tomography and ultrasonography revealed the tumor with clear border between the right liver and right kidney, and some tumors in the right lobe of liver. Furthemore, angiography demonstrated the tumor with vascularization, accordingly he was diagnosed to have an adrenal carcinoma with liver metastasis and operated on. But the tumor enlarged the adrenal gland with the capsule, and was enucleated with parts of the liver and kidney. after operation the tumor was ecognized to be hepatocellular carcinoma with adrenal metastasis histopathologically. On ten months after operation he lives a healthy life.

A CASE OF MALIGNANT NON-FUNCTIONING ISLET CELL TUMOR WITH LIVER METASTASIS

We often have difficulties in dignosing an abdominal tumor as a non-functioning islet cell tumor preoperatively, because it has no characteristic symptoms. Subsequently, very few cases of the tumor have been reported thus far. A 47-year-old female was admitted to our hospital because of upper abdominal discomfort. Physical examinations revealed a fist-sized and elastic hard tumor in the upper abdomen. Ultrasonography and Computed tomography showed two tumors in the abdomen. One of them was found in the right lobe of liver and the another in the body and the tail of pancreas. Selective angiography revealed hypervascular tumors. No elevated serum levels of various endocrine hormones were noted. Accordingly, those tumors were diagnosed as non-functioning cel tumors preoperatively and the patient underwent resection of the pancreas and right lobectomy of liver. Postoperative histopathological and immunohistological examinations revealed malignancies. A case of malignant non-functioning islet cell tumor with liver metastasis was reported, together with a review of the literature.

Bronchobiliary fistula due to acute cholecystitis in a suprahepatic gall bladder

We describe a patient presenting with painless jaundice, anorexia and pruritus. The gall bladder was found to be lying above and behind a hypoplastic right lobe of liver. There was no evidence of cholangitis or biliary obstruction. The patient subsequently developed a bronchobiliary fistula with severe wheeze, cough and bile-stained sputum. Emergency percutaneous drainage of the gall bladder led to immediate cessation of bronchospasm and biloptysis, rendering the patient fit for definitive surgery.

SOL-detectability of liver SPECT--analysis of the structure of ROC-curve

The purpose of this study is to evaluate the clinical efficacy of liver SPECT (single photon emission computed tomography). The two examinations were performed in 76 cases with SOL (space occupying lesion) and 58 normal cases. The results of the image reading by the planar image only (PS) and that of the image reading by the combination of PS and SPECT (PS + SPECT) were analyzed by ROC (receiver operating characteristic) analysis. The ROC curves showed that SPECT appears to reduce the number of results which were equivocal by the image reading of PS only. The detectability of SPECT for SOL in the left lobe of liver was less than that of PS without statistical significance. However, the performance of SPECT for SOL in the right lobe of liver was significantly better than that of PS.

Sonographic Detection of Prenatal Liver Mass

Ultrasound examination is now performed on about 30% of all pregnancies. Although it is used primarily to estimate gestational age, viability, presentation, and placental site, detailed fetal anatomy is also disclosed. Many abnormalities are now detected prenatally which may not be clinically apparent at birth, and raise new dilemmas of patient management. We describe a large mass documented by ultrasound in the right lobe of liver in a 29-week-old fetus. Subsequent postnatal investigation confirmed the initial ultrasound findings and documented spontaneous regression.

Hepatic oxygen and glucose metabolism in the fetal lamb. Response to hypoxia.

Although the fetal liver is an active metabolic organ, its oxygen and glucose requirements have not previously been described. We measured hepatic blood flows and the oxygen and glucose differences across the liver in 12 late gestation fetal lambs in utero. Four animals were studied at least 1 wk postsurgically and again 2-5 d later to assess daily variations in hepatic blood flow and metabolism (group I). A second group of eight animals was studied 3-5 d postsurgically during a control period and during acute fetal hypoxia (group II). Under control conditions total hepatic blood flow averaged 400 ml/min per 100 g in both groups, and 75-80% was of umbilical origin. Liver blood flow and oxygen consumption were usually similar during repeated measurements, but in one animal varied considerably. During periods of normoxia, oxygen consumption for both the right and left lobes of liver was 4 ml/min per 100 g. Oxygen consumption of the whole liver accounted for 20% of total fetal oxygen consumption. This was achieved with oxygen extraction of 10-15%, so that hepatic venous blood was well oxygenated and provided an important source of oxygen for other fetal tissues. Under control conditions we could demonstrate no net hepatic uptake or release of glucose suggesting that the liver ultimately utilizes another carbon source to support its oxidative metabolism. During acute hypoxia total liver blood flow and its umbilical venous contribution both fell by 20%. Blood flow to the right lobe of the liver fell twice as much as that to the left lobe. Hepatic oxygen consumption was linearly related to oxygen delivery during the control and hypoxic periods. Consequently, right hepatic oxygen uptake fell by 45% whereas left hepatic oxygen uptake was unchanged, suggesting a functional difference between the lobes. During hypoxia glucose was released from both liver lobes; 6 mg/min per 100 g for the right lobe and 9 mg/min per 100 g for the left lobe. Total hepatic release of glucose was estimated to nearly equal umbilical uptake, so that 45% of the glucose available to fetal tissues was of hepatic origin. We conclude that the fetal liver responds to acute hypoxia by reducing its own oxygen consumption and releasing glucose to facilitate anaerobic metabolism.

Pyogenic liver abscesses in children.

Five children with pyogenic liver abscess were admitted to Institute of Child Health, Kabul during the period 1978 to 1980. All patients were males, and their ages ranged from 4 to 10 years. The clinical picture was characterized by fever, upper abdominal pain, enlarged tender liver with raised right dome of the diaphragm. The abscesses were located in the right lobe of liver in all cases, and they were solitary in three cases. Staphylococcus aureus was the etiologic agent in four cases and Escherichia coli in one. Open surgical drainage coupled with prompt parenteral antibiotic therapy in all cases seem to have favorably influenced the outcome. With a high index of suspicion pyogenic liver abscess in children can be diagnosed clinically without the aid of hepatic radionuclide scanning.

An autopsy case of collision tumor.

At autopsy of a 60‐year‐old male, the authors found two malignant tumors occurring in different organs. One was hepatocellular carcinoma originating in the right lobe of the liver, and the other was leiomyosarcoma occurring in the right retroperitoneal space. They collided at the edge of the right lobe of liver and mixed together. The mixed area showed structures of true carcinosarcoma.

Effect of anthropometrical parameters on portal vein diameter and liver size in a subset of Karachi based population

The purpose was to study the impact of anthropometrical parameters on portal vein diameter and liver size by ultrasound in a subset of Karachi population. Four hundred and fifty nine apparently healthy subjects were included in this cross sectional study. After recording weight and height of each subject, Portal vein diameter and both liver lobes were measured by gray scale ultrasonography. Students T test and ANOVA were applied for statistical analyses. With increasing age, portal vein diameter and right lobe of liver increased significantly (p value < 0.001). Increase in portal vein diameter was also observed with rise in body mass index (0.8 cm in underweight - 1.1 cm in obese subjects). Sizes of right and left liver lobes also increased with a rise in body mass index (p value < 0.001 and 0.001). Gender, however, did not have any effect on portal vein diameter and liver size. Age and body mass index are reliable parameters to consider for avoiding false positive diagnosis of hepatomegaly and portal hypertension. Knowing the right and left liver size with respect to anthropometrical measurements also assist a clinician in selecting a subject for liver transplantation.