- Primary Biliary Cirrhosis: A Clinicopathologic Analysis of Four Cases.
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Mi Kyung Kim, Yong Il Kim, Hyo Suck Lee, Chung Yong Kim
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Korean J Pathol. 1991;25(4):318-326.
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 Abstract
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- Primary biliary cirrhosis, a chronic, progressive, and often fatal cholestatic liver disease, is characterized by destruction of intrahepatic bile ducts, portal inflammation and scarring, and the eventual development of cirrhosis and liver failure. We reviewed four cases of primary biliary cirrhosis primarily suspected with peritoneoscopic liver biopsy specimens. All patients were female and their age ranged from 29 to 50 years(median age: 43.8 years).
Presenting symptoms were typically pruritus and/or upper abdominal discomfort. On physical examination, interus was presented in 3; hepatomegaly in 3; chronic liver disease stigmata in one. Co-existing autoimmune diseases such as Hashimoto' thyroiditis and Sjoegren' syndrome were found in 2 cases. Biochemical tests of liver function revealed a cholestatic pattern. An antimitochondrial-antibody test was positive in 2 out of 3 patients(75%). Increase levels of serum immunoglobulins, especially of IgM, were evident in 3 cases. Histologic staging(Ludwig et al.) disclosed stage I lesion in one, stage III in two, and stage IV in the remaining one.
- Secondary Biliary Cirrhosis in A Case with Intraductal Growth of Hepatocellular Carcinoma.
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Hyung Geun Song, Yong Il Kim, Chung Yong Kim, Soo Tae Kim
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Korean J Pathol. 1987;21(3):185-191.
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Abstract
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- A case of hepatocellular carcinoma (HCC) complicating with secondary biliary cirrhosis due to intrahepatic bile duct growth of the tumor is presented. The patient was 34 years-old male who had been suffered from right upper quadrant pain with intermittent fluctuating jaundice for 4 months. Left lobectomy specimen contained a single, 4 cm sized, relatively well circumscribed and partly protruding nodular HCC in the medial seqment of left lobe. It compressed the left hepatic duct, and the intra and extra-hepatic ducts were completely plugged with tumor casts (extending to the common bile duct at the operating table).
Remaining hepatic parenclyma was the seat of advanced secondary biliary cirrhosis in which were abundance of HBsAg-containing hepatocytes possibily representing a HBsAg carrier status. Biliary cirrhosis in HCC is an extremely rare manifestation, reflecting the delayed adequate clinical procedure by unusual pattern of obstructive jaundice. In such a case presenting as persisting and fluctuating obstructive jaundice in HCC, an intrabile duct tumor growth should be suspected.
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