ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00016.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00017.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—Histologic sequences in the liver of rodents exposed by inhalation to gaseous vinyl chloride were compared to the lesions in man exposed to the same agent, mainly in vinyl chloride polymerization plants. An identical sequence, starting with circumscribed proliferation of hepatocytes, soon followed by proliferation of a variety of sinusoidal cells and frequently associated with sinusoidal dilatation, progresses to intralobular and more frequently to trabecular angiosarcoma. Predominantly in young animals and rarely in man, hepatocellular carcinoma develops, but never cirrhosis. The sequence represents a dynamic process of competition between proliferating hepatocytes and sinusoidal cells, of hepatocytes with fibroplasia, between perisinusoidal fibrosis and sinusoidal dilatation, and of proliferation of various sinusoidal cells versus angiosarcoma. The great similarity in the evolution in man and rodents, rarely encountered in other experimental models, supports the prediction of human cancer from animal experiments. The precursor nodules differ from the nodules commonly observed in hepatocarcinogenesis by co‐proliferation of sinusoidal cells. The differences in the reactions between man and rodents bespeak a strong fibroblastic reactivity in man. Most important, the precursor lesion of mixed hepatocellular and sinusoidal cell proliferation may be of diagnostic value, being superior to conventional hepatic tests in detection of some initial environmental lesi

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00018.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—Five observers each examined 20 jaundiced patients, recording clinical signs and symptoms on a form which also gave the definitions used for the study. The balanced design of the study allowed examination for order effects, but none were found, except for a tendency for agreement on indicants with more than two categories to improve as the study progressed. Chance agreement was corrected by the use of kappa statistics which showed that 80% of the indicants showed agreement significantly greater than expected by chance. Certain indicants (dark urine, variability of jaundice, abdominal pain, character of liver edge and presence of spleen) showed no evidence of significant agreement, even though the indicants were frequently observed in both states – present or absent. The percentage of correct clinical diagnoses reached by the observers (without biochemical or any other information) varied between 65% and 84%. The consensus diagnosis was correct in 80% of cases. Agreement was higher if the diagnosis was simplified to a ‘Medical’ or ‘Surgical’ diagnosis, the observers' accuracy being between

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00019.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—A series of 30 patients is reported whose primary hepatic tumors had a distinctive histologic pattern that we have called “sclerosing hepatic carcinoma” (SHC). Sixty‐nine percent of those tested had hypercalcemia and low levels of serum phosphate. As comparison, 38 control patients who had either classical peripheral cholangiocarcinoma or typical hepatocellular carcinoma were studied. In the control group, only two patients, who also had bone metastases, had hypercalcemia. Sclerosing hepatic carcinoma is characterized by intense fibrosis in which the tubular neoplastic structures are embedded. Although the tumor in each patient superficially resembled peripheral cholangiocarcinoma, on close inspection 63% were found to be of apparent hepatocyte origin, 20% were apparently ductal, and 13% were mixed or not distinguishable. One patient's tumor had the pattern of the rare cholangiolocellular carcinoma. The difficulty of histological diagnosis was well illustrated by the fact that none of premortem biopsies in 16 patients was correctly interpreted unequivocally as primary carcinoma of the liver. Many were misinterpreted as metastatic adenocarcinomas, most frequently of pancreatic origin. We believe that, by describing clinicopathological features, more attention will be drawn to this unique carcinoma of liver

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00020.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—Ultrastructural investigation of liver biopsies from two patients with non‐A, non‐B hepatitis revealed cytoplasmic and nuclear alterations in the hepatocytes. The lesions in both patients, one with acute and one with chronic hepatitis, were similar and distinct from those previously described in other forms of hepatitis. These findings are compared with the reported findings in chimpanzee liver after inoculation with non‐A, non‐B infective material. The intranuclear findings are similar to the aggregations of 20–27 nm particles described in some infected chimpanzees, and the cytoplasmic alterations seem to be similar to the cytoplasmic structures and tubular arrangements reported in other inoculated chimpanzees. A striking finding of this study is the presence of both alterations together in the same biopsy in two different patients, suggesting that they represent a different stage of viral infection or different parts of the viral agent. It still remains to be proved that the ultrastructural particles indeed contain antigen(s) of the non‐A, non‐B hepatitis virus. The nuclear and cytoplasmic alterations are, however, characteristic for non‐A, non‐B hepatitis and are useful as ultrastructural hallmarks of thi

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00021.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—Material obtained by needle biopsy of the liver from 532 patients with cirrhosis who had previously been examined has been re‐evaluated using new and more restrictive histological criteria for the diagnosis of cirrhosis. The material was divided into four main groups: (A) cirrhosis, 287 biopsies; (B) probably cirrhosis, 101 biopsies; (C) compatible with but not diagnostic for cirrhosis, 89 biopsies; and (D) probably not cirrhosis, 11 biopsies. Group E consisted of 44 cases where no or insufficient material was available. The survival curves of the groups were significantly (P<0.05) different, with group D having the best survival followed by C, B and A. Clinical and laboratory manifestations of cirrhosis (more than five spider naevi, presence of ascites, daily alcohol intake of more than 50 g) were found significantly (P<0.05) more often among patients from group A, followed by patients from groups B, C and D. It is concluded that the more restrictive histological criteria for the diagnosis of cirrhosis in liver biopsies have clinical relevance, due to the prognostic and therapeutic implications of the diagnosis. The study also underlines the importance of specifying the criteria used when studies of patients with cirrhosis are repor

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00022.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—A commercially available water‐soluble resin, JB‐4, was tested using human liver biopsy tissue. Processing was rapid and satisfactory. Single or serial sections 1 μm thick could be obtained. Routine stains and immunoperoxidase methods gave good r

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00023.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00024.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00025.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY