Occult hepatocellular carcinoma in cirrhosis: Value of ultrasound-guided biopsy of portal vein system thrombus

Joly, Jean‐Paul; Delamarre, J; Razafimahaleo, Arilaza; Sevestre, Henri; Tossou, H; Capron, Jean‐Pierre

doi:10.1007/bf00201778

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…3,4 Tumor thrombus formation into the portal and splenic veins is also very common in primary liver cancer, [5][6][7][8][9][10] but there are few studies reporting tumor thrombus formation in the umbilical vein.…”

Section: Discussionmentioning

confidence: 99%

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Sonographic diagnosis of tumor thrombus formation in the umbilical vein: A case report

Pei¹,

Zhang

He³

et al. 2011

J of Clinical Ultrasound

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Section: Discussionmentioning

confidence: 99%

“…It is not uncommon to see compensatory reopening of the umbilical vein in the presence of cirrhotic portal hypertension 3, 4. Tumor thrombus formation into the portal and splenic veins is also very common in primary liver cancer,5–10 but there are few studies reporting tumor thrombus formation in the umbilical vein.…”

Section: Discussionmentioning

confidence: 99%

Sonographic diagnosis of tumor thrombus formation in the umbilical vein: A case report

Pei¹,

Zhang

He³

et al. 2011

J of Clinical Ultrasound

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“…Percutaneous transhepatic sampling of a PVT for the diagnosis of HCC was first described by Joly et al in 1993 [ 11 ]. HCC was diagnosed in this case by percutaneous transhepatic US-guided biopsy from the left PVT after failure of both US and CT to detect any hepatic mass.…”

Section: Discussionmentioning

confidence: 99%

Role of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Portal Vein Thrombus in the Diagnosis and Staging of Hepatocellular Carcinoma

et al. 2021

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Background/Aims: Malignant portal vein thrombus (PVT) is found in up to 44% of patients with hepatocellular carcinoma (HCC). The nature of the thrombus influences treatment selection. The aim of this study was to assess the safety and efficacy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in determining the nature of PVT in liver cirrhosis and/or HCC.Methods: A prospective study was conducted in 34 patients with liver cirrhosis and/or HCC with PVT. Under EUS guidance, PVT was punctured using a 22 G FNA needle (Cook Medical, Bloomington, IN, USA) followed by monitoring of the puncture tract using color Doppler. Patients were followed for adverse events 2 hours after recovery.Results: Throughout the 30-month study period, 34 patients, including 24 males with a mean age of 59±8 years, were enrolled. There were 8 patients with known HCC and 26 with no liver masses detected by computed tomography (CT). EUS-FNA from PVT was positive for malignancy in 3 patients (8.8%), of which only 1 patient was diagnosed with HCC by CT and 2 patients were newly diagnosed with HCC after EUS-FNA. No major complications were reported.Conclusions: EUS-FNA is a safe and effective technique for determining the nature of PVT that does not fulfill the malignant criteria via imaging studies in patients with liver cirrhosis and/or HCC.

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Percutaneous fine-needle aspiration of portal vein thrombi as a staging technique for hepatocellular carcinoma. Cytologic findings of 46 patients

Dusenbery

Dodd

Carr

1995

Cancer

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Background. Detection of portal vein tumor invasion in patients with hepatocellular carcinoma (HCC) is important in determining therapy and prognosis. Fine‐needle aspiration (FNA) of a portal vein thrombus under ultrasound guidance facilitates the distinction of malignant from benign thrombus without resorting to laparotomy. In this study, the FNA findings of 46 patients who underwent this procedure are described. Methods. Cytologic findings of 48 aspirations from 46 patients who underwent percutaneous ultrasound‐guided portal vein FNA were reviewed. Results. Twenty‐nine of the 46 patients had a prior or concurrent biopsy‐confirmed diagnosis of HCC at the time of portal vein FNA. On cytologic review, 39 of the aspirates were positive for malignancy, 6 were negative, and 3 were suspicious. Histologic follow‐up of three of the six patients with negative aspirates confirmed bland thrombi in their portal veins. No complications resulted from the FNA procedure. Of the 39 aspirates positive for HCC, 22 were well differentiated, 5 were well to moderately differentiated, 9 were moderately differentiated, and 3 were poorly differentiated. In all except the poorly differentiated tumors, a trabecular cellular arrangement was detected in either smears or cell blocks. The cytologic findings in these aspirates, in general, mirror those found in aspirates of HCC in the liver proper. Conclusions. Portal vein FNA is an effective, well tolerated method for disease staging of patients with HCC. When used as the initial diagnostic procedure, in selected patients, it can provide the diagnosis and staging information simultaneously.

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Occult hepatocellular carcinoma in cirrhosis: Value of ultrasound-guided biopsy of portal vein system thrombus

Cited by 7 publications

References 12 publications

Sonographic diagnosis of tumor thrombus formation in the umbilical vein: A case report

Sonographic diagnosis of tumor thrombus formation in the umbilical vein: A case report

Role of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Portal Vein Thrombus in the Diagnosis and Staging of Hepatocellular Carcinoma

Percutaneous fine-needle aspiration of portal vein thrombi as a staging technique for hepatocellular carcinoma. Cytologic findings of 46 patients

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