The pruritus of cholestasis

✍ Scribed by C. N. Ghent

• Book ID: 102246193
• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 20 KB
• Volume: 30
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.510300228

✦ Synopsis

iron overload were present, as opposed to some areas of large liver cell dysplasia and clear cell foci. Small encapsulated clusters of necrotic tumoral hepatocytes were found in the peritoneum. Slides of the ruptured tumor were reviewed, and the diagnosis of a macrotrabecular, well-differentiated HCC (Edmondson grade 2) was confirmed. None of the following attributable risk factors for HCC were found: hepatitis B virus (serum DNA), hepatitis C virus (serum RNA), iron overload, alcohol, tobacco, oral contraceptive pills or drugs, diabetes, or personal or family history of liver or biliary disease.

Ectopic liver, often linked to the liver by a stalk, should be differentiated from a pedonculated tumor. In our experience, we found 3 cases of pedonculated HCC out of 67 cases of HCC developed on noncirrhotic liver. According to Arakawa, ectopic liver could be more prone to malignant transformation because of metabolic dysfunction. Although this is a possibility, one must remember that in HCC developed on so-called normal liver (without cirrhosis, chronic active hepatitis, or fibrosis), absence of known risk factors is not a rare event. The presence of foci of large liver cell dysplasia and clear cells, lesions shown to be associated with the occurrence of HCC in cirrhosis, could indicate that this patient, even in the absence of cirrhosis, is more prone to develop an HCC.