https://scholars.lib.ntu.edu.tw/handle/123456789/568855
標題: | Rapid hepatic failure associated with a contracted liver mimicking cirrhosis in a case of nasopharyngeal carcinoma with liver metastasis | 作者: | Hwang Y.-T. PEI-JER CHEN JIA-HORNG KAO Wang T.-D. Wang H.-H. Chu J.-S. Su I.-J. DING-SHINN CHEN |
公開日期: | 1996 | 出版社: | Blackwell Publishing Ltd | 卷: | 16 | 期: | 4 | 起(迄)頁: | 283-287 | 來源出版物: | Liver | 摘要: | A 46-year-old women had an undifferentiated nonkeratinizing nasopharyngeal carcinoma, locally controlled by radiotherapy. Initially, she had normal liver function tests and normal hepatic ultrasonography. Seven months later, she experienced a rapidly progressive hepatic failure manifested by the development of ascites, elevation of serum bilirubin level, and prolongation of prothrombin time. Imaging studies showed a contracted liver and serum biochemical tests were compatible with chronic liver disease, except for an increase of alkaline phosphatase and γ-glutamyl transpeptidase levels. An endoscopic retrograde cholangiogram was compatible with changes of sclerosing cholangitis. The patient died of hepatic decompensation within two months. A liver necropsy disclosed diffuse infiltration of carcinoma cells into the hepatic sinusoids and obliterative angio-invasion of the tumor cells with massive fibrotic stroma replacing almost all hepatocytes. In situ hybridization demonstrated expression of Epstein-Barr virus transcripts EBER1 in the tumor cells and proved a metastatic nasopharyngeal carcinoma. The contracted liver is likely to be explained by the tumor-associated desmoplastic change and the obliterative angio-invasion of the tumor. It is important to be aware that, although rare, such an unusual pattern of liver metastasis may mimick cirrhosis clinically and cause rapid hepatic failure in patients with nasopharyngeal carcinoma. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84984580933&doi=10.1111%2fj.1600-0676.1996.tb00744.x&partnerID=40&md5=67a3dacff0f69d44e57ad368260eb0de https://scholars.lib.ntu.edu.tw/handle/123456789/568855 |
ISSN: | 0106-9543 | DOI: | 10.1111/j.1600-0676.1996.tb00744.x | SDG/關鍵字: | alkaline phosphatase; bilirubin; gamma glutamyltransferase; adult; alkaline phosphatase blood level; article; ascites; autopsy; bilirubin blood level; case report; diagnostic imaging; differential diagnosis; echography; endoscopic retrograde cholangiopancreatography; Epstein Barr virus; female; gamma glutamyl transferase blood level; human; in situ hybridization; liver cirrhosis; liver failure; liver function test; liver metastasis; liver sinusoid; nasopharynx carcinoma; prothrombin time; sclerosing cholangitis |
顯示於: | 臨床醫學研究所 |
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