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BACKGROUND: Focal nodular hyperplasia (FNH) commonly occurs in women; it is usually asymptomatic and sometimes difficult to differentiate from hepatocellular carcinoma (HCC). CASE SUMMARY: A large space-occupying lesion in the right lobe of the liver was incidentally detected in an adult man and diagnosed as HCC. Transcatheter arterial chemoembolization was applied once monthly for 2 years, but the lesion did not decrease in size. It was revealed by biopsy to be FNH. Eleven years later, the patient underwent liver resection due to hemorrhage and the pathological examination confirmed FNH. CONCLUSION: For a space-occupying lesion, it is prerequisite to pathologically confirm the diagnosis and the corresponding intervention can be effective.
RESUMO
Primary hyperoxaluria type I (PH1), the most severe form of primary hyperoxalurias, is a liver disease of the metabolic defect in glyoxylate detoxification that can be corrected by liver transplantation. A 21-year-old man presented to our center after 4 months of regular hemodialysis for kidney failure caused by nephrolithiasis. A diagnosis of PH1 was confirmed by mutations of the AGXT gene. Left lateral sectionectomy of the native liver was performed; and auxiliary partial orthotopic liver transplantation (APOLT) and kidney transplantation were carried out synchronously using a living donor. After transplantation, the patient's plasma oxalate and creatinine levels substantially decreased and the patient recovered well with good dual grafts function. APOLT and kidney transplantation can compensate the liver deficient in liver enzyme production and aid the renal elimination of oxalate, thus serving as an effective treatment option for patients with PH1. In conclusion, left lateral sectionectomy of the native liver and combined living-related liver-kidney transplantation can be a surgical option for PH1.
Assuntos
Hepatectomia , Hiperoxalúria Primária/cirurgia , Transplante de Rim , Transplante de Fígado , Humanos , Doadores Vivos , Masculino , Adulto JovemRESUMO
OBJECTIVE: To construct protein fingerprints in serum and to early diagnose chronic allograft nephropathy (CAN) using surface enhanced laser ionization/desorption-time of flight-mass spectrometry (SELDI-TOF-MS). METHODS: Serum protein spectra were detected by SELDI-TOF-MS and weak cation exchange (CM10), which were from long-term survival patients with well-functioning kidney allograft (LS) (n = 24) and CAN (n = 15), and then biomarkers were screened through the analysis of database with Biomarker Wizard and Biomarker Pattern softwares. RESULTS: 78 protein peaks of interest were generated in each sample, 18 protein spectra statistically show difference between LS and CAN (P < 0.05), 6 of which (m/z 2476.0, 3078.7, 3190.5, 4076.5, 4506.0, 6178.4) statistically show significant difference (P < 0.01), a single biomarker (m/z 3078.7) differentiated LTS and CAN (P = 0.0001), it was upregulated in the former and downregulated in the latter, its diagnostic sensitivity and specificity were 87.5% and 81.8% respectively. Its cost-effective value is 0.307. CONCLUSION: Establishment of protein fingerprint signature in serum by SELDI-TOF-MS is clinically predictive of CAN.