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It is important to detect liver involvement in extranodal lesions in malignant hematologic disorders to make accurate diagnoses and estimate their clinical stage. We report seven cases of malignant lymphoma and a case of histiocytosis X. All patients expressed positive C-reactive protein and a high erythrocyte sedimentation rate, and a high serum value of alkaline phosphatase or lactic dehydrogenase was seen. Image analyses revealed enlarged livers without any space-occupying lesions. Peritoneoscopy with liver biopsy showed a diffuse presence of white maculae or peliosis hepatis on the liver surface among all the patients, and granulomas with or without malignant cells were observed histologically and congestion was seen in the lobules. Thus, peritoneoscopy with liver biopsy appears to be a useful tool not only to detect early liver involvement in malignant hematologic disorders but also to make their accurate diagnosis.

We encountered a patient with a ciliated hepatic foregut cyst (CHFC), which is an uncommon cystic lesion of the liver and hard to distinguish from malignant tumor in imaging features. Cases of CHFC are very rare, five cases were reported in the 19th century and 53 cases in the 20th century. The histogenesis of CHFC is still unclear, but most authors consider that it could arise from the embryonic foregut. A few cases of CHFC mimicking neoplasm were reported. When the diagnosis of CHFC was obtained by fine needle aspiration, close follow-up is necessary in order to find early malignant change. [Copyright &y& Elsevier]

We describe liver fibrosis caused by iron overload after a long history of blood transfusion in a patient with chronic renal failure. Pertinent laboratory data were: serum (s)-Fe 148 microg/dl; unsaturated iron binding capacity (UIBC) 14 microg/dl; s-ferritin 9350 ng/ml; human leukocyte antigen (HLA) A2, A24, B39, B55, Cw1, Cw7. Computed tomography revealed a high density in the liver, and laparoscopy revealed a brown liver. Liver histology showed bridging fibrosis from portal tracts. A heavy iron deposit was seen in Kupffer cells as well as in hepatocytes surrounded by fibrosis around the portal tracts. Immunocytochemistry revealed alpha-smooth muscle actin in many stellate cells distributed along the fibrotic area, and electron microscopy revealed infiltrating myofibroblastic stellate cells coexisting with collagen fibers around degenerated hepatocytes containing iron deposits. The findings are consistent with the notion that stellate cells play an important role in liver fibrogenesis in both genetic and transfusional iron overload hemochromatosis. [ABSTRACT FROM AUTHOR]

Apoptosis plays a major role in the regression of mitogen (lead nitrate)-induced hepatic hyperplasia. We compared the in situ end-labeling (ISEL) technique with the conventional detection of apoptotic bodies in this process. In hematoxylin and eosin (H&E) sections, apoptosis is usually recognizable by the presence of apoptotic bodies (apoptosis phase 2). Although the early phase of apoptosis (apoptosis phase 1) can be detected as a prekaryorrhectic appearance in H&E sections, it is difficult to detect and is easily overlooked. On the other hand, ISEL presents intense staining mainly in phase 1 and weak or negative staining in phase 2. Thus, simultaneous investigation by these two methods in two serial sections is the most reliable way to calculate the incidence of apoptosis and gives us precise information on the stages of apoptosis in situ. Since the colorized signals of ISEL are much easier to detect than apoptotic bodies in H&E sections, ISEL is particularly useful for liver tissues, where the incidence of apoptosis is low. [ABSTRACT FROM AUTHOR]