Primary hepatic malignant fibrous histiocytoma (MFH) is a rare entity with ill-defined clinicopathologic characteristics. We present the largest series to date (7 cases) of primary hepatic MFH, a systematic review of 27 cases published in the English literature, and an analysis of prognostic factors including ezrin expression. The 2 men and 5 women in our series were 34 to 80 years old (average 61 y) and presented with abdominal pain (6/7), systemic symptoms of low-grade fever, malaise, anorexia and weight loss (4/7), and spiking fever (1/7). One case was an incidental finding. Computed tomography and ultrasound revealed a well-demarcated solitary heterogeneous low-density mass ranging from 5.5 to 20 cm (average 12 cm) in largest dimension (5/7), or multiple small nodules up to 2 cm in diameter (1/7) or a 10 cm multiloculated cystic lesion owing to extensive necrosis (1/7). Histologically, a storiform-pleomorphic pattern with variable degrees of necrosis predominated (6/7). A myxoid pattern was seen in only 1 case and this case lacked necrosis. Lymphoplasmacytic infiltration was seen in 3/7 of the cases. Tumors were grade I (1/7), grade II (2/7), grade III (4/7), stage pT1 (4/7), pT2 (1/7), pT4 (1/7), and pT4, cM1 (1/7) at diagnosis. Three patients with tumor cell ezrin immunoreactivity score >or=1 died of tumor within 1 year. Two patients with tumor cell ezrin immunoreactivity score <1 survived >4 years after surgery. Combined analysis of our series and previously reported cases suggest that primary hepatic MFH possess certain characteristic clinicopathologic features that may help in making the diagnosis and in differentiating it from other more common neoplasms in the liver. The prognosis of hepatic MFH depends primarily on tumor size and stage at the time of diagnosis. Ezrin expression in tumor cells can provide additional prognostic information and may be a potential target for new adjuvant therapies.

Abstract. The aim of the present study was to investigate the effects of vaccination with the hepatitis B vaccine (HBVac) in HB surface antibody (HBsAb)-negative pregnant mothers on the vertical transmission of HB virus (HBV) from father to infant. All the fathers tested positive for the serum HBV DNA and HB surface antigen (HBsAg) markers. The pregnant females were divided into an observation group or a control group depending on whether their serum was HBsAb-negative or positive. A total of 93 healthy individuals without HBV infection were included in a blank group, while 96 females who were serum HBV marker-negative or HB core antibody (HBcAb)-positive/(HBsAb)-negative were included in the observation group. The control group comprised 89 females who all tested positive for serum HBsAb, HB envelope antibodies and HBcAb. In the observation group, the positive rate of HBV DNA in the newborns was 7.29% (7/96), the positive rate of HBsAg was 3.13% (3/96) and the positive rate of HBsAb was 81.3% (78/96). In the control group, the positive rates of HBV DNA, HBsAg and HBsAb in the newborns were 4.49% (4/89), 2.25% (2/89) and 89.9% (80/89), respectively. No statistically significant differences were observed between the two groups. Therefore, the results of the present study indicate that HBVac treatment for HBsAb-negative pregnant females may have a positive role in blocking the vertical transmission of HBV from father to infant, as long as the vaccination is able to induce the production of a sufficient quantity of HBsAb. The HBVac exhibited no difference compared with pre-pregnancy HBsAb in blocking the vertical transmission of HBV from father to infant.

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