ABSTRACT
Intrahepatic cholangiocarcinoma (ICC) is a rare type of primary liver cancer that arises from intrahepatic bile ducts. Its etiopathogenesis has been considered to be independent of the presence of chronic viral hepatitis infections or cirrhosis. These factors, particularly the hepatitis C virus, have been reported to play a role in the development of cholangiocarcinoma in a few studies, with inconclusive results. We report 2 cases of ICC that presented with a background of hepatitis B virus (HBV) infection and discuss the possible pathophysiological relationships between ICC and HBV infection, with an emphasis on the x gene of HBV.
Subject(s)
Bile Duct Neoplasms/virology , Bile Ducts, Intrahepatic/virology , Cholangiocarcinoma/virology , Hepatitis B/complications , Bile Duct Neoplasms/pathology , Bile Duct Neoplasms/physiopathology , Bile Ducts, Intrahepatic/pathology , Cholangiocarcinoma/pathology , Cholangiocarcinoma/physiopathology , Hepatitis B/pathology , Hepatitis B/physiopathology , Humans , Hypertension/complications , Magnetic Resonance Imaging , Male , Middle Aged , Smoking , Tomography, X-Ray ComputedABSTRACT
Besides the classical manifestations, leptospirosis may rarely occur with erythroid hypoplasia and/or pancytopenia. In this study, we reported two cases of leptospirosis presented with pancytopenia as the prevailing manifestation. In addition, the presence of pancytopenia in leptospirosis is reviewed. In both patients, the outcome was favourable as the bone marrow aplasia reversed completely after treatment with intravenous penicillin. In conclusion, this case study suggests that Leptospira infection should be included in the differential diagnosis of febrile pancytopenia, even in the absence of classical signs of severe disease as jaundice, meningitis, renal failure and pulmonary infiltrates.
