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Journal articles on the topic 'Solid liver lesions'

Author: Grafiati

Published: 11 March 2023

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1

Morana, Giovanni, Luigi Grazioli, Miles A. Kirchin, Maria Pia Bondioni, Niccolò Faccioli, Alessandro Guarise, and Günther Schneider. "Solid Hypervascular Liver Lesions." Investigative Radiology 46, no. 4 (April 2011): 225–39. http://dx.doi.org/10.1097/rli.0b013e3181feee3a.

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2

Nalaini, Farhad, Fatemeh Shahbazi, Seyedeh Maryam Mousavinezhad, Ali Ansari, and Mohammadgharib Salehi. "Diagnostic accuracy of apparent diffusion coefficient (ADC) value in differentiating malignant from benign solid liver lesions: a systematic review and meta-analysis." British Journal of Radiology 94, no. 1123 (July 1, 2021): 20210059. http://dx.doi.org/10.1259/bjr.20210059.

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Objectives: We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted (DW)-MRI in the characterization of solid benign and malignant liver lesions, and to assess their value in discriminating these lesions in daily routine practice. Methods: A systematic review of PubMed, Embase, Scopus, and Web of Science was conducted to retrieve studies that used ADC values for differentiating solid benign/dysplastic nodules and malignant liver lesions. A bivariate random-effects model with pooled sensitivity and specificity values with 95% CI (confidence interval) was used. This meta-analysis was performed on the per-lesion basis. Summary receiver operating characteristic (SROC) plot and area under curve (AUC) were created. Results: A total of 14 original articles were retrieved. The combined (95% CI) sensitivity and specificity of mean ADC values for differentiating solid benign from malignant lesions were 78% (67–86%) and 74% (64–81%), respectively. The pooled (95% CI) positive and negative LRs were respectively 3 (2.3–3.8) and 0.3 (0.21–0.43). The DOR (95% CI) was 10 (7–15). The AUC (95% CI) of the SROC plot was 82% (78–85%). Reporting bias was negligible (p value of regression test = 0.36). Mean size of malignant lesions and breathing pattern of MRI were found to be sources of heterogeneity of pooled sensitivity. Conclusion: ADC measurement independently may not be an optimal diagnostic imaging method for differentiating solid malignant from solid benign hepatic lesions. The meta-analysis showed that ADC measurement had moderate diagnostic accuracy for characterizing solid liver lesions. Further prospective and comparative studies with pre-specified ADC thresholds could be performed to investigate the best MRI protocol and ADC threshold for characterizing solid liver lesions. Advances in knowledge: ADC measurement by DW-MRI does not have a good diagnostic performance to differentiate solid malignant from solid benign lesions. Therefore, we suggest not using ADC values in clinical practice to evaluate solid liver lesions.

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3

Wu, Size, Dongsheng Zuo, and Yamin Hong. "The Prevalence of Hyperechoic Rim in Solid Focal Liver Lesions and Its Implication." Journal of Diagnostic Medical Sonography 35, no. 1 (September 7, 2018): 3–8. http://dx.doi.org/10.1177/8756479318798365.

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The objective of this study was to investigate the prevalence and clinical implications of the hyperechoic rim of liver focal solid lesions. A retrospective review was conducted of sonograms of focal liver lesions with a hyperechoic rim, as well as relative examinations such as computed tomography, magnetic resonance imaging, biopsy, resection, and histopathology reports. A cohort of 10 232 patients was found to have solid focal liver lesions (2030 malignant, 8202 benign). A hyperechoic rim was determined in 182 hemangiomas, 2 granulomas, 2 hepatocellular carcinomas (HCCs), and 4 other malignancies. There were significant differences between malignant and benign lesions ( P < .001), between HCCs and hemangiomas ( P < .001), between malignancies and hemangiomas ( P < .001), between HCCs and granulomas ( P = .044), and between other malignancies and granulomas ( P = .005). There was no significant difference between liver granulomas and hemangiomas ( P = .656). In this study, a hyperechoic rim in solid focal liver lesions appeared mainly in hemangiomas, granulomas, and rarely in malignant lesions.

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Belghiti, Jacques, François Cauchy, Valérie Paradis, and Valérie Vilgrain. "Diagnosis and management of solid benign liver lesions." Nature Reviews Gastroenterology & Hepatology 11, no. 12 (September 2, 2014): 737–49. http://dx.doi.org/10.1038/nrgastro.2014.151.

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5

Wasif, Nabil, Sebastian Sasu, William C. Conway, and Anton Bilchik. "Focal Nodular Hyperplasia: Report of an Unusual Case and Review of the Literature." American Surgeon 74, no. 11 (November 2008): 1100–1103. http://dx.doi.org/10.1177/000313480807401112.

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Focal nodular hyperplasia (FNH) is the second most common benign lesion of the liver and a common differential in the workup of solid liver lesions. With increasing use of modern imaging modalities FNH is becoming clinically more relevant. We present a case of pedunculated FNH presenting as a pericholecystic mass. This was resected laparoscopically due to persistent symptoms and uncertainty in diagnosis. We summarize the current literature with regard to the diagnosis, etiology, and management of FNH lesions.

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6

Sbeit, Wisam, Anas Kadah, Amir Mari, Mahmud Mahamid, and Tawfik Khoury. "A Comprehensive Narrative Review on the Evolving Role of Endoscopic Ultrasound in Focal Solid Liver Lesions Diagnosis and Management." Diagnostics 10, no. 9 (September 11, 2020): 688. http://dx.doi.org/10.3390/diagnostics10090688.

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The implications of endoscopic ultrasound (EUS) have expanded considerably in recent years to cover more fields in invasive gastroenterology practice, as both an investigative and therapeutic modality. The utility of EUS in the diagnosis and management of focal liver lesions has gained a special attractiveness recently. The EUS probe proximity to the liver and its excellent spatial resolution enables real-time images coupled with several enhancement techniques, such as contrast-enhanced (CE) EUS. Aside from its notable capability to execute targeted biopsies and therapeutic interventions, EUS has developed into a hopeful therapeutic tool for the management of solid liver lesions. Herein, we provide a comprehensive state-of-the-art review on the efficacy and safety of EUS in the diagnosis and management of focal solid liver lesions. Medline/PubMed and Embase database searches were conducted by two separate authors (T.K. and W.S.), all relevant studies were assessed, and relevant data was extracted and fully reported. EUS-guided diagnosis of focal liver lesions by sonographic morphologic appearance and cytological and histopathological finding of biopsies obtained via fine needle aspiration/biopsy have been shown to significantly improve the diagnosis of solid liver lesions compared with traditional imaging tools. Similarly, EUS-guided treatment has been shown to consistently have excellent technical success, high efficacy, and minor adverse events. The evolving valuable evidences of EUS utility might satisfy the unmet need of optimizing management of focal solid liver lesions.

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Bariş, Zeren, Pelin Börcek, Kemal Murat Haberal, and Figen Özçay. "Solid Liver Lesions in an Infant With Neonatal Cholestasis." Journal of Pediatric Hematology/Oncology 39, no. 8 (November 2017): 626–28. http://dx.doi.org/10.1097/mph.0000000000000936.

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8

Mondragón-Sánchez, Ricardo, Elvira Gómez-Gómez, Ana Lilia Garduño-López, Alejandro Mondragón-Sánchez, M. Nancy Martínez-González, and Juan Manuel Ruiz-Molina. "Surgical management of benign solid and cystic liver lesions." Clinical and Translational Oncology 6, no. 5 (June 2004): 295–301. http://dx.doi.org/10.1007/bf02711837.

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9

Balekuduru, Avinash Bhat, Amit Kumar Dutta, Sanjeev Kumar Nagaruru, Shamim Sheik, Suneetha Parandhamaiah Kurella, and Satyaprakash Bonthala Subbaraj. "Comparison of Diagnostic Yield of Endoscopic Ultrasound-guided Fine-needle Aspiration Cytology and Cell Block in Solid Lesions." Journal of Digestive Endoscopy 08, no. 04 (October 2017): 176–81. http://dx.doi.org/10.4103/jde.jde_53_17.

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ABSTRACT Background and Aim: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a procedure of choice for the diagnostic evaluation of submucosal and periluminal lesions. Tissue sample can be obtained by EUS-FNA cytology (FNAC) or cell block (CB). The aim of the present study is to compare diagnostic yield of EUS-FNA CB and cytology in the absence of onsite pathologist following a protocol-based EUS-FNA approach in solid lesions. Patients and Methods: Participants who underwent EUS-FNA at our center for solid submucosal or periluminal lesions (pancreas, lymph node, and liver) between 2014 and 2016 were included, retrospectively. The indication for the procedure along with the clinical and other investigation details and the final etiological diagnosis were recorded on uniform structured data forms. The diagnostic yield of cytology and CB were compared using McNemar’s test. The P < 0.05 was considered statistically significant. Results: EUS-FNA for solid lesion was performed in 130 lesions in 101 patients during the study period. Their mean age was 52.5 ± 12 years and 42.5% were female. Pancreatic masses were the most common lesions (37.7%) followed by lymph nodes (36.9%). Submucosal lesions (17.7%) and liver lesions (7.7%) accounted for rest of the cases. The overall diagnostic yield for EUS-FNAC (70%) and CB (74.6%) was not significantly different (P = 0.3) and their combined yield was 85.3%. For the 23 patients with submucosal lesion, diagnostic yield of CB (82.6%) was significantly better than cytology (47.8%, P = 0.04). Conclusions: EUS-guided CB has better yield compared to cytology in gastrointestinal submucosal lesions. The combination of CB with cytology improves the overall yield of the procedure; and hence, they should be considered complimentary rather than alternatives.

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10

Yang, Da-wei, Ke-yang Wang, Xun Yao, Hui-yi Ye, Tao Jiang, Yuan Liu, Jia-yin Gao, Min Chen, Cheng Zhou, and Zheng-han Yang. "Diffusion-Weighted Imaging with Two Differentb-Values in Detection of Solid Focal Liver Lesions." BioMed Research International 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/8128207.

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One hundred and eighty-two consecutive patients with suspected liver disease were recruited to receive diffusion-weighted imaging (DWI) with two differentb-values, in comparison with T2-weighted imaging (T2WI). The detection rate of three MR sequences in solid focal liver lesions (FLLs) and subgroup analyses were performed. Our prospective study found that DWI600 was equivalent to DWI100 and T2WI for the detection of solid FLLs overall but was significantly more accurate in the detection of malignant solid FLLs and lesions larger than 10 mm.

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Bhattacharya, Gaurav, Michael Kabiri, and Laura Callan. "What you need to know about imaging the liver." University of Western Ontario Medical Journal 83, no. 1 (December 23, 2014): 12–16. http://dx.doi.org/10.5206/uwomj.v83i1.4476.

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Hepatic cancers are an increasing source of morbidity and mortality in the developing and the developed world. In this paper, we highlight the current imaging modalities used for various cystic and solid hepatic lesions. The rationale behind selection of these modalities and an efficient evidence‐based step‐bystep diagnostic algorithm are presented. Emphasis is placed on both identifying as well as differentiating between a benign, primary malignant and metastatic lesion.

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12

ashraf, obaid, naseer choh, and omair shah. "Qualitative And Quantitative Magnetic Resonance Imaging Assessment Of Focal Liver Lesions: A Study To Evaluate The Role Of Different MRI Sequences." Journal of Research in Clinical Medicine 9, no. 1 (June 7, 2021): 27. http://dx.doi.org/10.34172/jrcm.2021.027.

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Background: Focal liver lesions have a broad differential diagnosis. MRI with its improved soft tissue characterization and newer sequences can significantly narrow the differentials especially when discriminating benign from malignant lesions. Methods: T1, T1 IN AND OUT OF PHASE, T2, LONG TE T2 AND Diffusion Weighted Imaging was done in 159 patients with USG documented focal liver lesion. Qualitative and quantitative assessment of ADC values and long TE images was done and a threshold for differentiating benign from malignant lesions was obtained. The MRI diagnosis was compared with final diagnosis obtained from histopathology in most cases or follow up and other tests (markers and RBC scan) were histopathology was not available. Sensitivity, specificity and accuracy of MRI sequences in differentiating various focal lesions were obtained. Results: T1 weighted images were useful for identifying fat, hemorrhage and iron within the lesions. T2 weighted imaging was able to correctly classify 82.0% lesions as malignant and 83.7% lesions as benign. Long TE T2 images were highly accurate in distinguishing haemangiomas and cysts from solid lesions. On diffusion-weighted (DW) imaging, 89.5% (i.e. 60 out of 67) lesions were correctly classified as malignant and 88.0% (i.e. 81 out of 92) lesions were correctly classified as benign. Threshold ADC value of 1.37 × 10-3 mm2/s is highly accurate for differentiating malignant from benign lesions. Conclusion: DWI is a sine qua non in liver lesion assessment allowing improved detection and characterization. Long TE T2 weighted imaging can accurately detect haemangiomas and cysts and rule out metastasis.

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13

Cheung, Helen M. C., Paul J. Karanicolas, Natalie Coburn, Calvin Law, and Laurent Milot. "Late Gadolinium Hyperintensity of Suspected Colorectal Liver Metastases on Gadofosveset-Enhanced Magnetic Resonance Imaging: A Predictor of Benignity and a Potential Problem-Solving Tool." Canadian Association of Radiologists Journal 70, no. 3 (August 2019): 239–45. http://dx.doi.org/10.1016/j.carj.2019.03.006.

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PurposeLate gadolinium hyperintensity (LGH) is sometimes seen in colorectal liver metastasis (CRLM) and represents a significant diagnostic pitfall due to overlap with LGH in benign hemangiomas; therefore, the objective of this study was to determine the prevalence of LGH and the ability of LGH to differentiate between CRLM and benign lesions with intravascular (gadofosveset) vs extracellular contrast agents (gadobutrol).MethodsPatients with known colorectal cancer and suspected liver lesions were prospectively recruited into this institutional review board–approved, single institution study and received magnetic resonance imaging of the liver with gadofosveset and gadobutrol. The prevalence of LGH for CRLMs and solid benign lesions was determined. Receiver operating characteristics curves were determined for the presence of LGH as a predictor of benignity. The utility of LGH to differentiate between CRLM and solid benign lesions using gadofosveset vs gadobutrol was compared using the generalized estimating equation.ResultsTwenty-five patients with 131 solid focal liver lesions were recruited. The prevalence of LGH of CRLMs was 11.2% (95% confidence interval [CI]: 0.5%–21.8%) with gadofosveset vs 63.7% (95% CI: 45.7%–81.7%) with gadobutrol. The area under the receiver operating characteristic curve for the presence of LGH as a predictor of benignity was 0.86 using gadofosveset vs 0.75 using gadobutrol. Both LGH ( P = .003) and the interaction of contrast agent and LGH ( P = .003) statistically significantly differentiated CRLM from benign lesions.ConclusionLGH is more common with extracellular than with intravascular contrast agents and is statistically significantly associated with benign lesions rather than metastases.

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14

Podgórska, Joanna, Katarzyna Pasicz, Witold Skrzyński, Bogumił Gołębiewski, Piotr Kuś, Jakub Jasieniak, Anna Kiliszczyk, et al. "Perfusion-Diffusion Ratio: A New IVIM Approach in Differentiating Solid Benign and Malignant Primary Lesions of the Liver." BioMed Research International 2022 (January 15, 2022): 1–9. http://dx.doi.org/10.1155/2022/2957759.

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Introduction. In order to improve the efficacy of intravoxel incoherent motion (IVIM) parameters in characterising specific tissues, a new concept is introduced: the perfusion–diffusion ratio (PDR), which expresses the relationship between the signal S b decline rate as a result of IVIM and the rate of signal S b decline due to diffusion. The aim of this study was to investigate this novel approach in the differentiation of solid primary liver lesions. Material and Methods. Eighty-three patients referred for liver MRI between August 2017 and January 2020 with a suspected liver tumour were prospectively examined with the standard liver MRI protocol extended by DWI-IVIM sequence. Patients with no liver lesions, haemangiomas, or metastases were excluded. The final study population consisted of 34 patients with primary solid liver masses, 9 with FNH, 4 with regenerative nodules, 10 with HCC, and 11 with CCC. The PDR coefficient was introduced, defined as the ratio of the rate of signal S b decrease due to the IVIM effect to the rate of signal S b decrease due to the diffusion process, for b = 0 . Results. No significant differences were found between benign and malignant lesions in the case of IVIM parameters ( f , D , or D ∗ ) and ADC. Significant differences were observed only for PDR, with lower values for malignant lesions ( p = 0.03 ). The ROC analysis yielded an AUC value for PDR equal to 0.74, with a cut-off value of 5.06, sensitivity of 81%, specificity of 77%, and accuracy of 79%. Conclusion. PDR proved to be more effective than IVIM parameters and ADC in the differentiation of solid benign and malignant primary liver lesions.

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15

Alsaidan, Mohammed Saud, Ohoud Zaid Aljarbou, and Waleed Alajroush. "Kaposi Sarcoma in a Child after Fanconi Anemia-Induced Haploidentical Hematopoietic Stem Cell Transplant: A Case Report." Children 10, no. 2 (January 19, 2023): 188. http://dx.doi.org/10.3390/children10020188.

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Kaposi sarcoma is relatively common after solid organ transplantation, but very rare after hematopoietic stem cell transplant (HSCT). Here we are reporting a rare case of Kaposi sarcoma in a child after HSCT. An 11-year-old boy with Fanconi anemia was treated by haploidentical HSCT from his father. Three weeks after transplantation, the patient developed severe graft-versus-host disease (GVHD) which was treated by immunosuppressive therapy and extracorporeal photopheresis. Approximately 6.5 months after HSCT, the patient had asymptomatic nodular skin lesions over the scalp, chest, and face. Histopathological examination showed typical findings of Kaposi sarcoma. Later, additional lesions in the liver and oral cavity were confirmed. Liver biopsy was positive for HHV-8 antibodies. The patient was continued on Sirolimus which was already being used for the treatment of GVHD. Cutaneous lesions were also treated with topical timolol 0.5% ophthalmic solution. Within six months, cutaneous and mucous membrane lesions were completely resolved. Follow-up abdominal ultrasound and MRI showed the disappearance of the hepatic lesion.

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16

Numminen, K., H. Isoniemi, J. Halavaara, P. Tervahartiala, H. Mäkisalo, L. Laasonen, and K. Höckerstedt. "Preoperative assessment of focal liver lesions: multidetector computed tomography challenges magnetic resonance imaging." Acta Radiologica 46, no. 1 (February 2005): 9–15. http://dx.doi.org/10.1080/02841850510016108.

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Purpose: To investigate prospectively multidetector computed tomography (CT) (MDCT) and magnetic resonance (MR) imaging (MRI) in the preoperative assessment of focal liver lesions. Material and Methods: Multiphasic MDCT and conventional gadolinium‐enhanced MRI were performed on 31 consecutive patients prior to hepatic surgery. All images were blindly analyzed as consensus reading. Lesion counts and their relation to vascular structures and possible extrahepatic disease were determined. The data from the MDCT and MRI were compared with the results obtained by intraoperative ultrasound (IOUS) and palpation. Histopathologic verification was available. Results: At surgery, IOUS and palpation revealed 45 solid liver lesions. From these, preoperative MDCT detected 43 (96%) and MRI 35 (78%) deposits. MDCT performed statistically better than MRI in lesion detection ( P = 0.008). Assessment of lesion vascular proximity was correctly determined by MDCT in 98% of patients and by MRI in 87%. Statistical difference was found ( P = 0.002). IOUS and palpation changed the preoperative surgical plan as a result of extrahepatic disease in 8/31 (26%) cases. In MDCT as well in MRI extrahepatic involvement was suspected in two cases. Conclusion: MDCT was superior to MRI and nearly equal to IOUS in liver lesion detection and in the determination of lesion vascular proximity. However, both techniques fail to reliably detect extrahepatic disease.

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17

Assy, Nimer, Gattas Nasser, Agness Djibre, Zaza Beniashvili, Saad Elias, and Jamal Zidan. "Characteristics of common solid liver lesions and recommendations for diagnostic workup." World Journal of Gastroenterology 15, no. 26 (2009): 3217. http://dx.doi.org/10.3748/wjg.15.3217.

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18

González-Añó, M., J. Cervera-Deval, J. H. García-Vila, F. Bordón-Ferré, S. Ambit-Capdevila, R. Piqueras-Olmeda, J. Jornet-Fayos, S. Gil-Sánchez, S. F. Marco-Domenech, and V. Cortés-Vizcaíno. "Characterization of solid liver lesions with color and pulsed Doppler imaging." Abdominal Imaging 24, no. 2 (March 1, 1999): 137–43. http://dx.doi.org/10.1007/s002619900462.

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19

Katkhouda, Namir, Michael Hurwitz, Jean Gugenheim, Eli Mavor, Rodney J. Mason, Donald J. Waldrep, Raymond T. Rivera, et al. "Laparoscopic Management of Benign Solid and Cystic Lesions of the Liver." Annals of Surgery 229, no. 4 (April 1999): 460–66. http://dx.doi.org/10.1097/00000658-199904000-00003.

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20

Dietrich, Christoph F., Claudio Tana, Cosmin Caraiani, and Yi Dong. "Contrast enhanced ultrasound (CEUS) imaging of solid benign focal liver lesions." Expert Review of Gastroenterology & Hepatology 12, no. 5 (April 24, 2018): 479–89. http://dx.doi.org/10.1080/17474124.2018.1464389.

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21

Nagolu, Harshavardhan, Sudhakar Kattoju, Chidambaranathan Natesan, Meera Krishnakumar, and Sunil Kumar. "Role of Acoustic Radiation Force Impulse Elastography in the Characterization of Focal Solid Hepatic Lesions." Journal of Clinical Imaging Science 8 (February 21, 2018): 5. http://dx.doi.org/10.4103/jcis.jcis_64_17.

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Objective: The purpose of the study is to investigate the usefulness of acoustic radiation force impulse (ARFI) elastography in the characterization of focal solid liver lesions as benign, malignant, or metastatic using ARFI two-dimensional (2D) imaging and ARFI quantification (shear wave velocities [SWVs]). Materials and Methods: Sixty lesions were included in this study. The lesions were classified into three groups: Group I included benign lesions (n = 25), Group II included malignant lesions (n = 27), and Group III included metastatic lesions (n = 8). ARFI elastography was performed in all these patients using a Siemens ACUSON S 2000™ ultrasound machine. Stiffness and size of the lesions were assessed on ARFI 2D images in correlation with B-mode ultrasound images. SWVs were obtained in these lesions for the quantification of stiffness. Results: In ARFI 2D images, malignant lesions were predominantly stiffer and larger, while benign lesions were softer and similar in size (P < 0.05). The mean SWVs in benign, malignant, and metastatic lesions were 1.30 ± 0.35 m/s, 2.93 ± 0.75 m/s, and 2.77 ± 0.90 m/s, respectively. The area under receiver operating characteristic curve of SWV for differentiating benign from malignant lesions was 0.877, suggesting fair accuracy (95% confidence interval: 0.777–0.976); with a cutoff value of 2 m/s, showing sensitivity: 92%; specificity: 96%; positive predictive value: 96%; negative predictive value: 93% (P < 0.05). Statistically significant difference exists in SWV of benign and malignant or metastatic lesions. Conclusion: ARFI elastography with 2D imaging and quantification might be useful in the characterization of benign and malignant liver lesions.

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Lakic, Tanja, Mirjana Zivojinov, Milivoje Vukovic, Jelena Ilic-Sabo, and Tamara Boskovic. "Mesenchymal hamartoma of the liver in adults: Case report." Medical review 67, no. 11-12 (2014): 399–403. http://dx.doi.org/10.2298/mpns1412399l.

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Introduction. Mesenchymal hamartoma of the liver is a benign lesion presenting as an enlarging abdominal mass in children less than 2 years of age. Fewer than 5% cases are present in individuals over 5 years of age, and this lesion is extremely rare in adults. It may affect the left or the right lobe of liver as a cystic or solid mass or both components may be present. The pathogenesis remains incompletely understood, but these lesions have generally been considered to represent a development abnormality in the bile duct plate formation. Case Report. In this report, we present a case of a 44-year-old man who was surgically treated at the Department of Abdominal, Endocrine and Transplantation Surgery of the Clinical Center of Vojvodina due to cystic lesion in the liver segment IV that had been verified by computed tomography imaging diagnostics. The patient was sent from a smaller health center with the diagnosis of echinococcosis. After the adequate preparation of the patient, surgical excision of the liver cystic lesion was done. Once a thorough histological examination had been performed, the diagnosis of mesenchymal hamartoma was made. Conclusion. Mesenchymal hamartoma of the liver is a benign tumor resulting from abnormal, intra-uterine development of bile ducts and has a delayed clinical manifestation, thus this lesion appears to be related to the processes of maturation. It is potentially premalignant lesion presenting as a solid and/or cystic neoplasm. Symptoms, laboratory results and radiographic imaging are nonspecific and inconclusive, so surgical excision of the whole lesion is the imperative for the definitive diagnosis.

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Pankaj Jain, Tarun, Wen Ter Kan, Sean Edward, Helen Fernon, and Renuvathy Kansan Naider. "Evaluation of ADCratio on liver MRI diffusion to discriminate benign versus malignant solid liver lesions." European Journal of Radiology Open 5 (2018): 209–14. http://dx.doi.org/10.1016/j.ejro.2018.10.002.

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A., Faizel, Kardam N., Gehlot K., and Ola S. "COMPARATIVE EVALUATION OF ULTRASONOGRAPHY AND COMPUTED TOMOGRAPHY IN FOCAL LIVER LESIONS." International Journal of Advanced Research 10, no. 06 (June 30, 2022): 131–37. http://dx.doi.org/10.21474/ijar01/14865.

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Introduction: Liver diseases are among the commonestcauses of morbidity and mortality and accurate characterization is an important goal of diagnostic imaging.The aim of the study is to establish the role of ultrasonography and CT in differentiation and early diagnosis of focal liver lesions and to correlate the findings with pathological diagnosis. Methodology:This prospective comparative observational and hospital based study was conducted on 100 patients. USG and CT were performed on focal hepatic mass patients. Diagnostic value of USG were compared with to those of CT. Results: Ultrasonography and CT evaluation results were compared with final diagnosis by FNAC/ HPR.USG showed maximum cases among malignant lesions were HCC (20%) and among benign lesions were liver abscess (19%).CT diagnosed maximum number of cases as metastasis (19%) in malignant lesions andalmost equal percentage of hemangiomas(15%) and liver abscess(16%) among the benign lesions. The sensitivity and specificity of USG in diagnosing lesions turned out to be slightly less than that of CT. Conclusion:The study concluded that ultrasonography can be adopted as the initial imaging modality with advantages of differentiating cystic from solid lesions, relationship with critical structures and can guide FNAC and biopsy. CT has a comparatively higher sensitivity and specificity in detection of lesions and can help narrow the differentials.

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Wang, Hong, Hong-Bo Wang, Xiu-Juan Hou, Xiao-Lei Wang, and Jia-Wei Tian. "Application of three-dimensional ultrasonography in the diagnosis of liver solid lesions." World Chinese Journal of Digestology 17, no. 25 (2009): 2640. http://dx.doi.org/10.11569/wcjd.v17.i25.2640.

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26

Nikolova, St, and N. Grigorov. "The possibilities of contrast ultrasound in differential diagnosis of solid liver lesions." European Journal of Ultrasound 7 (February 1998): S4. http://dx.doi.org/10.1016/s0929-8266(97)80114-0.

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27

Gallotti, A., M. D’Onofrio, L. Romanini, V. Cantisani, and R. Pozzi Mucelli. "Acoustic Radiation Force Impulse (ARFI) ultrasound imaging of solid focal liver lesions." European Journal of Radiology 81, no. 3 (March 2012): 451–55. http://dx.doi.org/10.1016/j.ejrad.2010.12.071.

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28

Malatjalian, Dickran K., John Morris, and Audley Bodurtha. "Isolation of Klebsiella Pneumoniae from an Hepatic Inflammatory Pseudotumour." Canadian Journal of Gastroenterology 6, no. 2 (1992): 84–86. http://dx.doi.org/10.1155/1992/594034.

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lnflammatory pseudotumours of the liver are rare, solid mass lesions (often mistaken for malignancy) and although inflammatory in nature, are obscure in etiology and pathogenesis. An hepatic inflammatory pseudotumour is presented in which cultures obtained from the lesion intraoperatively grew Klebsiella pneumoniae. This is the first case of an hepatic inflammatory pseudotumour in which a microorganism has been identified. The isolation of K pneumoniae suggests that inflammatory pseudotumours may arise from a low grade infection with chronic inflammatory tissue response.

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29

Dumonceau, Jean-Marc, Pierre Deprez, Christian Jenssen, Julio Iglesias-Garcia, Alberto Larghi, Geoffroy Vanbiervliet, Guruprasad Aithal, et al. "Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline – Updated January 2017." Endoscopy 49, no. 07 (May 16, 2017): 695–714. http://dx.doi.org/10.1055/s-0043-109021.

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MAIN RECOMMENDATIONSFor pancreatic solid lesions, ESGE recommends performing endoscopic ultrasound (EUS)-guided sampling as first-line procedure when a pathological diagnosis is required. Alternatively, percutaneous sampling may be considered in metastatic disease.Strong recommendation, moderate quality evidence.In the case of negative or inconclusive results and a high degree of suspicion of malignant disease, ESGE suggests re-evaluating the pathology slides, repeating EUS-guided sampling, or surgery.Weak recommendation, low quality evidence.In patients with chronic pancreatitis associated with a pancreatic mass, EUS-guided sampling results that do not confirm cancer should be interpreted with caution.Strong recommendation, low quality evidence.For pancreatic cystic lesions (PCLs), ESGE recommends EUS-guided sampling for biochemical analyses plus cytopathological examination if a precise diagnosis may change patient management, except for lesions ≤ 10 mm in diameter with no high risk stigmata. If the volume of PCL aspirate is small, it is recommended that carcinoembryonic antigen (CEA) level determination be done as the first analysis.Strong recommendation, low quality evidence.For esophageal cancer, ESGE suggests performing EUS-guided sampling for the assessment of regional lymph nodes (LNs) in T1 (and, depending on local treatment policy, T2) adenocarcinoma and of lesions suspicious for metastasis such as distant LNs, left liver lobe lesions, and suspected peritoneal carcinomatosis.Weak recommendation, low quality evidence.For lymphadenopathy of unknown origin, ESGE recommends performing EUS-guided (or alternatively endobronchial ultrasound [EBUS]-guided) sampling if the pathological result is likely to affect patient management and no superficial lymphadenopathy is easily accessible.Strong recommendation, moderate quality evidence.In the case of solid liver masses suspicious for metastasis, ESGE suggests performing EUS-guided sampling if the pathological result is likely to affect patient management, and (i) the lesion is poorly accessible/not detected at percutaneous imaging, or (ii) a sample obtained via the percutaneous route repeatedly yielded an inconclusive result.Weak recommendation, low quality evidence.

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Imrani, Kaoutar, Tlaite Oubaddi, Hounayda Jerguigue, Rachida Latib, and Youssef Omor. "Liver metastasis mimicking an abscess." BJR|case reports 7, no. 4 (July 2021): 20200201. http://dx.doi.org/10.1259/bjrcr.20200201.

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Hepatic metastases from carcinoid tumours are typically solid, hypervascular lesions on imaging. The cystic form, mimicking an abscess, is extremely rare. We report a case of a 48-year-old female presenting with a large hepatic mass that was diagnosed as a hepatic abscess, but the ultrasound-guided biopsy showed well-differentiated grade 1 neuroendocrine tumour. CT scan of chest, abdomen and pelvis was performed, looking for the primary tumour, it revealed an endobronchial mass of the right inferior lobe. Lung biopsy by rigid bronchoscopy was taken confirming the diagnosis of a typical carcinoid tumour.

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Mak, S., M. Kawka, T. M. H. Gall, S. Y. Qiu, and L. R. Jiao. "Solid Benign Liver Lesions: Accuracy of Clinical Diagnosis Using Conventional Radiological Techniques at Time of Liver Resection." HPB 23 (2021): S144. http://dx.doi.org/10.1016/j.hpb.2020.11.350.

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Zwart, Koen, Dieuwertje Ruigrok, Magda de Graaf-Bos, Roel Goldschmeding, Miriam Koopman, and Guus M. Bol. "Spontaneous Complete Regression of Colon Cancer Liver Metastases in a Lung Transplant Patient: A Case Report." Case Reports in Transplantation 2023 (January 12, 2023): 1–7. http://dx.doi.org/10.1155/2023/9643370.

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Background. Cancer has become an important cause of death in solid organ transplant patients. The cause of malignancies in patients with solid organ transplants is multifactorial, but the use of intensive immunosuppression is regarded as an important factor. We describe the spontaneous, complete regression of colon cancer liver metastases, without initiation of antitumor therapy, in a solid organ transplant patient after modulation of immunosuppressants. Case Presentation. A 59-year-old female was admitted with fever, general discomfort, and elevated liver enzymes. She had received a single lung transplant, five years prior, for end-stage chronic obstructive pulmonary disease. Abdominal ultrasound and a computed tomography scan showed extensive liver lesions, and liver biopsy determined that the lesions were liver metastases originating from a colonic adenocarcinoma. Histopathologic analysis revealed that the primary tumor and liver metastases were mismatch repair-deficient (BRAFV600E mutant and MLH1/PMS2-deficient), also known as a microsatellite instable tumor. The patient’s clinical condition deteriorated rapidly, and she was discharged home with palliative care. No antitumor treatment was initiated. Additionally, there was a short period without any immunosuppressants. Unexpectedly, her clinical condition improved, and complete regression of liver metastases was observed on imaging two months later. Unfortunately, the patient developed rejection of her lung transplant and succumbed to pulmonary disease six months following her cancer diagnosis. The autopsy confirmed the primary colon tumor location and complete regression of >40 liver metastases. Conclusions. Disinhibition and reset of the host immune response could have led to immune destruction of the liver metastases of this patient’s immunogenic dMMR colon carcinoma. This case underscores the huge impact that temporary relief from immunosuppressive therapy could have on tumor homeostasis. Balanced management of care for organ transplant recipients with malignancies requires a multidisciplinary approach involving medical oncologists and transplant physicians to reach the best quality of care in these complex cases.

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Shaked, Oren, Evan S. Siegelman, Kim Olthoff, and K. Rajender Reddy. "Biologic and Clinical Features of Benign Solid and Cystic Lesions of the Liver." Clinical Gastroenterology and Hepatology 9, no. 7 (July 2011): 547–62. http://dx.doi.org/10.1016/j.cgh.2011.03.007.

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Chung, Andrew D. "Fat-Containing Lesions of the Liver: A Review of Differential Diagnoses." Canadian Association of Radiologists Journal 71, no. 1 (January 22, 2020): 12–18. http://dx.doi.org/10.1177/0846537119885693.

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The presence of intralesional fat provides an invaluable tool for narrowing the differential diagnosis for both benign and malignant neoplasms of the abdomen and pelvis. The ability to characterize intralesional fat is further expanded by the ability of magnetic resonance imaging to detect small quantities (intravoxel) of fat. The differential diagnosis of fat-containing lesions arising in the liver is broader than that of many other solid organs. However, this differential can be further refined depending on the type of fat (macroscopic vs intravoxel) and with the use of ancillary imaging findings. Radiologists must be aware of benign and malignant mimickers of common lesions.

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Itonaga, Masahiro, Reiko Ashida, and Masayuki Kitano. "Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement." Diagnostics 10, no. 11 (October 30, 2020): 888. http://dx.doi.org/10.3390/diagnostics10110888.

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Although endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is useful in the differential diagnosis of solid pancreatic lesions, lymph nodes, and liver lesions, inadequate sampling may result in an incorrect pathological diagnosis. The accuracy of EUS for the evaluation of pancreatobiliary lesions may be increased by image enhancement technologies, including contrast-enhanced harmonic (CH)-EUS and EUS-elastography. These methods can provide information that complement EUS-FNA for the diagnosis and staging of pancreatobiliary cancer, and can help to identify the EUS-FNA target, reducing the requirement for repeat FNA.

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Bansal, Nalini, and Brahmananda Satapathy. "Primary multifocal cystic signet ring neuroendocrine tumor of liver: a case report." Journal of Liver Cancer 21, no. 2 (September 30, 2021): 187–93. http://dx.doi.org/10.17998/jlc.2021.09.17.

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Primary signet ring neuroendocrine tumors of the liver are extremely rare tumors. Morphologically, they mimic signet ring cell adenocarcinomas; however, the absence of mucin by special stains and the expression of neuroendocrine markers help to diagnose these tumors. We herein report a case of a 47-year-old female who presented with multiple solid and cystic lesions in both liver lobes, which were initially suggested to be biliary cystadenocarcinoma on imaging. Liver biopsy of the lesion revealed the presence of a signet ring neoplasm with diffuse expression of synaptophysin and pan-cytokeratin. The case was subsequently diagnosed as a primary hepatic signet ring neuroendocrine tumor. The patient was offered 3 cycles of chemotherapy and is well preserved after 14 months of diagnosis. Although this is an extremely rare entity, its possibility should be considered in the differential diagnosis of neoplasms characterized by signet ring cell morphology.

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Guzman, Grace, Scott J. Cotler, Amy Y. Lin, Andrew J. Maniotis, and Robert Folberg. "A Pilot Study of Vasculogenic Mimicry Immunohistochemical Expression in Hepatocellular Carcinoma." Archives of Pathology & Laboratory Medicine 131, no. 12 (December 1, 2007): 1776–81. http://dx.doi.org/10.5858/2007-131-1776-apsovm.

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Abstract Context.—The “de novo” formation of fluid-conducting patterns by tumor cells, termed vasculogenic mimicry (VM), is associated with increased mortality in many different solid tumors. Objective.—To identify VM patterns in hepatocellular carcinoma (HCC) and to determine whether these patterns were associated with more rapid tumor recurrence after orthotopic liver transplantation. Design.—Subjects included 20 patients who underwent orthotopic liver transplantation and were found to have HCC in the liver explant. Samples from 5 normal postmortem livers and 5 explanted livers with hepatitis C virus cirrhosis without HCC served as control tissues. Patterned matrix VM expression in HCC was identified by the presence of laminin-positive loops surrounding packets of tumor cells. Time to HCC recurrence after orthotopic liver transplantation was compared between patients with and without patterned VM expression. The relationships among VM in HCC, cause of chronic liver disease, serum α-fetoprotein level at the time of diagnosis, tissue expression by epidermal growth factor receptor, and endothelial markers including vascular endothelial growth factor and CD31 were assessed. Results.—Patterned matrix VM was identified in 11 of 20 primary HCC tissue samples. Vasculogenic mimicry was absent in all 10 control cases and was not identified in any area of dysplasia. The expression of VM in HCC lesions in liver explants was associated with more rapid posttransplant recurrence (P = .01). Vasculogenic mimicry was not associated with the cause of liver disease, serum α-fetoprotein level at time of diagnosis, or expression of epidermal growth factor receptor, vascular endothelial growth factor, or CD31. Conclusions.—Vasculogenic mimicry of the patterned matrix type is present in hepatocellular carcinoma and is associated with tumor recurrence after orthotopic liver transplantation. Vasculogenic mimicry lesions are not associated with endothelial markers in HCC.

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Li, Cheng, Jin Yao Teo, Jiaze Wu, Apoorva Gogna, Bien Soo Tan, London Lucien Ooi, Jimin Liu, and Haoyong Yu. "CREATION OF CLINICALLY-DIFFERENTIAL TUMOR MIMIC MODEL USING VASELINE-BASED MATERIALS WITH BARIUM SULFATE FOR THE VALIDATION OF REAL-TIME ULTRASOUND IMAGE-GUIDED LIVER BIOPSY SYSTEM." Biomedical Engineering: Applications, Basis and Communications 28, no. 01 (February 2016): 1650003. http://dx.doi.org/10.4015/s1016237216500034.

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Testing objects are important for the validation of developing biopsy systems. Unfortunately, they are very hard to obtain. Motivated by this issue, the purpose of this study is to develop a technique for the easy creation of a model to simulate tumors of different sizes inside porcine livers, which could be used for ultrasound image-guided liver biopsy amongst other applications, and evaluate its performance by comparing to the more widely-used approaches in-vivo and ex-vivo. In this study, a Vaseline-based tumor model, and a more widely-used agar-based tumor model to provide comparison with the proposed method were created and injected into porcine livers as biopsy targets. The clinician located simulated tumors using real-time 2D imaging under the guidance of a robotic arm to delivery the biopsy in ex-vivo and in-vivo experiments. The results show that the optimum tumor model was created from a mixture of Vaseline, glycerol, and barium sulfate which can be easily produced and injected. All Vaseline-based simulated tumors were of solid, palpable mass on gross examination, and ultrasound imaging revealed clearly visible lesions. The clinician successfully performed ultrasound image guided liver biopsy in all the trials (10/10) in the ex-vivo experiment, and 2 out of 3 trials (2/3) in the in-vivo experiment on this optimum tumor model. We described a novel technique of creating solid liver tumor models that can be used for ultrasound image-guided liver biopsy.

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Soussan, Michael, Christophe Aubé, Stéphane Bahrami, Jérôme Boursier, Dominique Charles Valla, and Valérie Vilgrain. "Incidental focal solid liver lesions: diagnostic performance of contrast-enhanced ultrasound and MR imaging." European Radiology 20, no. 7 (January 13, 2010): 1715–25. http://dx.doi.org/10.1007/s00330-009-1700-3.

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Stintzing, S., R. T. Hoffmann, V. Heinemann, M. Kufeld, and A. Muacevic. "Robotic radiosurgery of liver metastases of solid tumors." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e15049-e15049. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e15049.

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e15049 Background: The number of patients (pts) suffering from isolated liver metastases is growing. Although surgical excision is the treatment of choice many pts do not qualify for surgery. So local ablative techniques like radiofrequency ablation, laser induced thermal ablation therapy, brachytherapy and different external beam radiation therapies have been employed. We here report the therapeutic efficacy of a robotic radiosurgery device for local control of liver metastases of solid tumors. Methods: Patients with liver metastases not qualifying for surgery were treated with single session radiosurgery (24 Gy) using robotic image-guided real-time tumor tracking. In a prospective analysis, follow-up was done by MRI scanning at two months after the treatment, and subsequently at 3-month intervals to evaluate local control. For inclusion into the radiosurgery treatment protocol, tumor volumes had to be smaller than 80cc. Results: 27 pts (median age 62 years) with a total of 43 target lesions were evaluated. 17 pts were treated with single, 10 pts with multiple targets. Metastases (n=27) originated from: colon (12), rectum (2), pancreas (2), lung (1), bladder (2), malignant melanoma (1), stomach (1), cholangiocellular carcinoma (2), breast (1), ovary (1), appendix (1) and endometrium (1). Median tumor volume was 21cc (range 2.2–79.3). Median KPS was 100% (range 80–100). The median follow up was 12 months. 23 pts (85%) reached local control of the disease, 4 pts (15%) had local recurrence. Grade 2–4 adverse events due to cyberknife treatment were not observed. Conclusions: Robotic radiosurgery with image-guided real-time tumor tracking of liver metastases is a new and promising treatment approach for pts not eligible for surgical resection and might enhance the possibilities of multidisciplinary oncological treatment concepts. No significant financial relationships to disclose.

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Emamaullee, Juliet A., Klaudia Nowak, Marla Beach, Julinor Bacani, and A. M. James Shapiro. "Hepatic Epithelioid Hemangioendothelioma Presenting as an Enlarging Vascular Lesion within the Spleen." Case Reports in Transplantation 2018 (2018): 1–3. http://dx.doi.org/10.1155/2018/3948784.

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Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm with variable malignant potential that most often presents within the liver. Many patients present with bilobar or extrahepatic disease, and the current treatment paradigm involves liver transplantation, with favorable long term results. Up to 25% of patients are diagnosed incidentally following imaging for other indications, and confirmation of diagnosis requires histologic analysis, as there are no classical imaging features to distinguish hepatic EHE (HEHE) from other solid hepatic lesions. Here we describe a case of microscopic HEHE that was diagnosed following splenectomy for an enlarging vascular tumor within the spleen. Due to the unexpected diagnosis of EHE within the spleen and coexisting but stable appearing liver hemangiomata, a left hepatic lobectomy was performed. Explant histology revealed benign hemangiomata and diffuse, microscopic HEHE. The patient ultimately underwent liver transplantation. HEHE can be a challenging diagnosis, and this case emphasizes that any enlarging vascular lesion, even within the spleen, should prompt a high index of suspicion for HEHE in the setting of known hemangiomata.

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Little, J. M., Arthur Richardson, and Noel Tait. "Hepatic Dystychoma: A Five Year Experience." HPB Surgery 4, no. 4 (January 1, 1991): 291–97. http://dx.doi.org/10.1155/1991/96304.

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In 5 years, 64 solid hepatic lesions have been referred for diagnosis and management which have been found unexpectedly on organ imaging in well patients. We have called this lesion a “dystychoma”.Patients have undergone a two phase investigation programme which allows a diagnosis without admission to hospital in about 50% of cases. About three quarters of patients (47/64) have had nonneoplastic lesions, and about half (33/64) have had haemangiomas. About one patient in four (17/64) has had a neoplasm, and the neoplasm has been malignant in about one in six (11/64) of all patients.We stress the need to pursue the diagnosis in these patients. There were no reliable clinical, biochemical or imaging characteristics which individually distinguished benign from malignant lesions. Age over 55 years, an enlarged liver or a palpable liver mass and a raised serum alkaline phosphatase were all significantly more frequent with malignant tumours. The risk of malignancy rose with the number of risk factors, and all patients with all three risk factors had malignant tumours.Only 11 of the 64 patients were judged to have benefited by significant increase in quality or quantity of life as a result of what was frequently inappropriate organ imaging. There is no strong argument for replacing history taking and physical examination by CT scanning, ultrasound examination or other organ imaging.

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Davarpanah, Nicole N., Liza Lindenberg, Dereck W. Paul, Seth M. Steinberg, Deneise C. Francis, Marilise Anne Berniger, Juanita Weaver, et al. "18F-FDG-PET/CT imaging to assess response to treatment with cabozantinib at 4 weeks versus 8 weeks of therapy in patients (pts) with metastatic urothelial carcinoma (mUC)." Journal of Clinical Oncology 35, no. 6_suppl (February 20, 2017): 317. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.317.

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317 Background: This study investigates whether changes in 18F-FDG-PET/CT correlate with response to cabozantinib at an early time point (4 wks) versus the conventional time point of restaging (8 wks) in pts with mUC, using Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST). Methods: 68 pts with mUC in a single arm phase II clinical trial of cabozantinib underwent FDG-PET/CT scans at baseline, 4 and 8 wks. Up to 5 lesions with the highest Standard Uptake Value (SUV) were designated as target lesions. Response was determined using 2 versions of PERCIST (1 lesion vs top 5 lesions with highest FDG uptake) for FDG-PET/CT at 4 and 8 wks. PERCIST response classifications were compared to RECIST v1.1 at 8 wks. Results: 54 pts had evaluable disease. The single lesion 4 wk response by PERCIST showed 40% partial metabolic response (PMR), 33% stable metabolic disease (SMD), and 27% progressive metabolic disease (PMD). The single lesion 8 wk response by PERCIST showed 31% PMR, 31% SMD, and 38% PMD. The single lesion analysis coincided with multiple lesion PERCIST analysis in 86% of pts at 4 wks and 89% at 8 wks. The 4 wk PET/CT was predictive of the 8 wk PET/CT in 75% of single lesion and 76% of multiple lesion analyses. In lesion-based analysis, the 4 wk PET/CT was predictive of the 8 wk PET/CT in 74% of bone, 89% of lung, 77% of lymph node, 74% of soft tissue, and 58% of liver lesions. Only 42% of the 8 wk PERCIST and RECIST classifications coincided. At 8 wks, 40% showed response in FDG PET-CT restaging vs 7% complete/partial response by RECIST. Conclusions: The 4 wk PET/CT scan predicts the therapy response at the 8 wk PET/CT scan however the 4 wk scan overestimates the 8 wk response. The single lesion analysis by PERCIST correlates with the multiple lesion analysis and may have more clinical utility. In the lesion-based analysis, the 4 wk PET/CT scan is predictive of the 8 wk PET/CT for bone, lung, lymph node and soft tissue but not for liver lesions. Response classifications by PERCIST are not in agreement with response classifications by RECIST. Although the methods may be complementary, they are not interchangeable. Further studies are required to validate these findings. Clinical trial information: NCT01688999.

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Ahn, Su Joa, Jung Hoon Kim, Sang Min Lee, Sang Joon Park, and Joon Koo Han. "CT reconstruction algorithms affect histogram and texture analysis: evidence for liver parenchyma, focal solid liver lesions, and renal cysts." European Radiology 29, no. 8 (November 19, 2018): 4008–15. http://dx.doi.org/10.1007/s00330-018-5829-9.

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Pavic, Tajana, Ivana Mikolasevic, Dominik Kralj, Nina Blazevic, Anita Skrtic, Ivan Budimir, Ivan Lerotic, and Davor Hrabar. "Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?" Diagnostics 11, no. 11 (October 31, 2021): 2021. http://dx.doi.org/10.3390/diagnostics11112021.

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As the burden of liver disease in the general populace steadily increases, so does the need for both advanced diagnostic and treatment options. Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. This paper aims to summarize the growing role of endoscopic ultrasound in hepatology based on the search of the current literature. A number of applications of endoscopic ultrasound are reviewed, including both noninvasive methods and tissue acquisition in focal and diffuse liver disease, portal hypertension measurement, detection and management of gastric and esophageal varices, treatment of focal liver lesions and staging of pancreatobiliary malignancies, treatment of cystic and solid liver lesions, as well as liver abscess drainage. Both hepatologists and endoscopists should be aware of the evolving role of endoscopic ultrasound in liver disease. The inherent invasive nature of endoscopic examination limits its use to a targeted population identified using noninvasive methods. Endoscopic ultrasound is one the most versatile methods in gastroenterology, allowing immediate access with detection, sampling, and treatment of digestive tract pathology. Further expansion of its use in hepatology is immanent.

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Olsen, Sharla-Rae J., and Mohit Bhutani. "Multiple Cavitating Nodules in a Renal Transplant Recipient." Canadian Respiratory Journal 16, no. 6 (2009): 195–97. http://dx.doi.org/10.1155/2009/521548.

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Pulmonary nodules are common following solid organ transplantation and vary in etiology. Nodules with central cavitation are most likely to be of infectious origin in the post-transplant population. A novel presentation of post-transplant lymphoproliferative disorder manifesting as multiple cavitating pulmonary nodules is described. The patient, a 45-year-old female renal transplant recipient, presented with constitutional symptoms and a chest x-ray showing multiple bilateral cavitating lesions. A computed tomography scan confirmed innumerable, randomly dispersed, cavitating nodules in the lung parenchyma. Multiple large hypodense lesions were identified in the liver and spleen. The appearance of the native and transplanted kidneys was normal. A liver biopsy identified an Epstein-Barr virus-negative, diffuse, large B cell lymphoma. Repeat imaging after treatment with a cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone/prednisolone regimen demonstrated dramatic resolution of all lesions. The present case represents a unique radiographic presentation of post-transplant lymphoproliferative disorder not previously reported in the literature.

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Kumar, S., and K. Jabbar. "Serous Cystadenocarcinoma of Pancreas: A Rare Find." American Journal of Clinical Pathology 158, Supplement_1 (November 1, 2022): S60. http://dx.doi.org/10.1093/ajcp/aqac126.120.

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Abstract Introduction/Objective Pancreatic cystic neoplasms comprise 1-2% of pancreatic lesions and most of these lesions are cystadenomas. Serous cystadenocarcinoma is an extremely rare but known malignant condition described in the literature and the diagnosis is restricted to cases with distant metastasis of tumor beyond the pancreas. Per WHO, cytologic atypia, vascular, perineural, and adjacent organ and lymph node involvement by direct spread are insufficient for the diagnosis of serous cystadenocarcinoma. Methods/Case Report We report an interesting case of serous cystadenocarcinoma of pancreas in a 55-year-old male with medical history of prostate cancer was found to have a 15 cm mass pancreatic tail suspicious for neuroendocrine tumor and 5 small hepatic lesions suspicious for metastasis. The patient underwent subtotal pancreatectomy and splenectomy, and wedge resection of liver lesions. On gross examination, a yellow cystic mass was present in the pancreatic tail measuring 13.2 cm in the maximum dimension. H&E slides from the pancreas and liver demonstrated a neoplasm composed of cystic and solid areas, within a background of fibrosis and focal hemorrhage. Cystic areas showed microcysts composed of cells with clear cytoplasm and round to oval bland nuclei. Solid areas demonstrated almost no microcysts but sheets and clusters of cells with clear to scant cytoplasm, oval to round nuclei, few areas of atypical hyperchromatic cells, and occasional mitosis. Very focal clusters and cords of neuroendocrine cells, constituting less than 5% of the tumor volume were also identified. Immunohistochemical stains demonstrated the neoplastic cells both in cystic and solid areas were positive for CK7, CK19, MUC6, and inhibin. Ki67 demonstrated an overall proliferation index of 3%. Chromogranin and synaptophysin were negative within the solid and cystic components of the tumor, however, showed positive staining within neuroendocrine foci. Neoplastic cells were negative for all other tested markers including beta-catenin, ER, Hep-par 1, HMB45, IMP3, MART-1, PAX-8, and trypsin. RB1 expression was retained within neoplastic cells. Results (if a Case Study enter NA) N/A. Conclusion The differentiation between benign and malignant serous cystadenoma both histologically and clinically may be very difficult as some cases of serous cystadenocarcinoma may not show overt cytologic atypia. The presence of metastasis, which most often occurs in the liver is required for the diagnosis of serous cystadenocarcinoma.

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Solbiati, L., L. Cova, and T. Ierace. "Specificity of contrast-enhanced harmonic sonography for characterization of solid, incidentally detected focal liver lesions." Ultrasound in Medicine & Biology 29, no. 5 (May 2003): S23. http://dx.doi.org/10.1016/s0301-5629(03)00147-9.

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Quaia, Emilio. "The real capabilities of contrast-enhanced ultrasound in the characterization of solid focal liver lesions." European Radiology 21, no. 3 (November 24, 2010): 457–62. http://dx.doi.org/10.1007/s00330-010-2007-0.

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Elson, Charles O. "Exam 2: Biologic and Clinical Features of Benign Solid and Cystic Lesions of the Liver." Clinical Gastroenterology and Hepatology 9, no. 7 (July 2011): e71. http://dx.doi.org/10.1016/j.cgh.2011.05.008.

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