Endoscopic Liver Biopsy

Roberts, Susan H.; James, Oliver

doi:10.1016/s0140-6736(74)92275-2

Cited by 1 publication

(3 citation statements)

References 5 publications

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“…The presence of hepatocyte in biopsy or cytology examination was the clue of diagnosis for 19 cases. Among them, the most frequently observed presentation was peptic hepatitis (hepatocyte with a surrounding inflammatory reaction), which was found in nine cases, 10 , 13 , 18 , 22 , 25 , 28 , 31 , 35 , 37 and two cases did not have any apparent inflammation 9 , 14 and no information of inflammation was mentioned in five cases. 7 , 19 , 20 , 32 , 36 In the first article that described the features of peptic hepatitis, atypical hepatocytes were demonstrated.…”

Section: Resultsmentioning

confidence: 99%

“…Endoscopically, penetration into the liver could frequently appear as a polypoid or pseudotumoral mass that protruded from the central area of the ulcer bed. 8,9,13,14,21,24,[32][33][34][35][36] This feature, combined with the irregular ulcer ground and margin, the giant ulcer size (average size 5.1 cm for gastric ulcers and 2.4 cm for duodenal ulcers) and clinical features (weight loss and emaciation) always raised the potential for malignancy. However, as indicated by Padda et al, 24 an endoscopic biopsy had the potential risk of inducing active bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Under endoscope or during surgery, a large or giant ulcer (defined as the largest dimension of ≥3 cm for gastric ulcers 5 and 2 cm for duodenal ulcer 6 ) was described in 25 patients; A polypoid or pseudotumoral mass that protruded from the central area of the ulcer bed was mentioned frequently (in 11 cases 8,9,13,14,21,24,[32][33][34][35][36] ). Five ulcers had an irregular margin.…”

Section: Gross Manifestationsmentioning

confidence: 99%

See 2 more Smart Citations

Liver Involvement by Perforated Peptic Ulcer: A Systematic Review

Jiao¹,

Zhang²

2021

Journal of Clinical and Translational Pathology

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Background and Objective: Liver penetration by a confined perforation of peptic ulcer is a rare but severe event. Its clinical and pathological features are unclear. Methods: In total, 41 qualified English publications were identified using the PubMed database and one in-house case. Results: Among the 42 patients, 20 patients had liver involvement by a perforated duodenal ulcer and 22 by a gastric ulcer. Among the 23 cases of known ulcer histology, 2 ulcers were malignant and were adenocarcinomas in the gastric remnant and the remaining 21 ulcers were confirmed as histologically benign (for frequency of malignancy in duodenal versus gastric ulcers, p = 0.48). The presence of hepatocytes was the clue of diagnosis for 19 cases. The median ages of the patients were 64.5 years (95% Confidence Intervals [CI] 53.40-71.90) for duodenal ulcer and 65.5 years (95% CI: 59.23-70.95) for gastric ulcer, respectively. The male to female ratio was 1.5:1 for duodenal ulcers and 2:1 for gastric ulcers. Patients with liver involvement of a perforated gastric ulcer were more likely to have a larger ulcer (median largest dimension, 4.75 cm versus 2.5 cm, p = 0.014). Female patients with liver involvement of a gastric ulcer were older than male patients (median age 72 versus 60 years, p = 0.045). There were no differences in gender, region (Asia, Europe, America versus others), use of nonsteroidal anti-inflammatory drugs (n = 15), H. Pylori positivity (n = 10), possible history of peptic ulcer disease (n = 19) or mortality (n = 32) between duodenal and gastric ulcers. Conclusions: Careful histologic examination, clinicopathological correlation, and immunohistochemistry are critical to establish the diagnosis and avoid misdiagnosing liver involvement as malignancy.

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