Please use this identifier to cite or link to this item:
Type: Artigo de periódico
Title: Large Benign Hepatocellular Nodules In Cirrhosis Due To Chronic Venous Outflow Obstruction: Diagnostic Confusion With Hepatocellular Carcinoma.
Author: Oliveira, E C
Duarte, A G E
Boin, I F S F
Almeida, J R S
Escanhoela, C A F
Abstract: Budd-Chiari syndrome (BCS) in patients progressing to cirrhosis is an indication for liver transplantation. At this stage of disease, it is common to find large benign hepatocellular nodules (LBHNs) of undetermined cause that may be confused with hepatocellular carcinoma (HCC). Patients with indications for liver transplantation are currently classified according to the MELD (Model for End-Stage Liver Disease) severity score. When they fit Barcelona and Milan eligibility criteria for HCC, they receive 20 points. Thus, misdiagnosis of HCC leads to a privileged position on the waiting list. Herein, we have reported three BCS cases of cirrhotic patients who underwent liver transplantation; the pathologic results of their explanted livers showed LBHN. We analyzed three of 489 OLT who had chronic venous outflow obstruction (CVOO) the first case: was a 19-year-old man, with BCS of undetermined cause. The second 20-year-old female patients displayed BCS due to antiphospholipid syndrome the third, 45-year-old man had CVOO diagnosed preliminarily due to cryptogenic cirrhosis in the explanted liver. In the three cases, the nodules in the explant measured 0.5 to 2.4 cm. In the first case, the diagnosis was not in doubt; in the second case, 23 nodules were confused with HCC histologic evaluation, and in the third case three larger hypervascular nodules were misdiagnosed as HCC in the preoperative period despite low alpha-fetoprotein levels. In conclusion it is fundamental to recognize these benign lesions so as to avoid misdiagnosis, thereby allowing the proper selection of candidates for liver transplantation.
Subject: Adult
Budd-chiari Syndrome
Carcinoma, Hepatocellular
Diagnosis, Differential
Liver Cirrhosis
Liver Neoplasms
Liver Transplantation
Middle Aged
Waiting Lists
Citation: Transplantation Proceedings. v. 42, n. 10, p. 4116-8, 2010-Dec.
Rights: fechado
Identifier DOI: 10.1016/j.transproceed.2010.09.070
Date Issue: 2010
Appears in Collections:Unicamp - Artigos e Outros Documentos

Files in This Item:
File SizeFormat 
pmed_21168640.pdf769.25 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.