Systemic AA amyloidosis induced by liver cell adenoma.

Fiévet, P.; Sevestre, H; Boudjelal, M; Lh, Noël; Kemeny, F; Franco, Dominique; Delamarre, J; Capron, Jean‐Pierre

doi:10.1136/gut.31.3.361

Cited by 20 publications

(6 citation statements)

References 12 publications

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“…Only four of our patients with AL disease died of hepatic insufficiency, and none of the AA patients died. The only patient described in the literature with AA amyloidosis and hepatic failure had a primary hepatocellular carcinoma,28 a condition known to cause an acute phase response 29. In AL amyloidosis, projected median survival with intensive cytotoxic chemotherapy is more than four years16 and liver transplantation may be a useful supportive measure in patients who develop hepatic failure before they have responded to treatment.…”

Section: Discussionmentioning

confidence: 99%

The liver in systemic amyloidosis: insights from ¹²³I serum amyloid P component scintigraphy in 484 patients

Lovat

Persey

Madhoo

et al. 1998

Gut

110

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Background and aims-The liver is frequently involved in amyloidosis but the significance of hepatic amyloid has not been systematically studied. We have previously developed scintigraphy with 123 I serum amyloid P component ( 123 I-SAP) to identify and monitor amyloid deposits quantitatively in vivo and we report here our findings in hepatic amyloidosis. Methods-Between 1988 and 1995, 805 patients with clinically suspected or biopsy proven systemic amyloidosis were evaluated. One hundred and thirty eight patients had AA amyloidosis, 180 had AL amyloidosis, 99 had hereditary amyloid syndromes, and 67 had dialysis related ( 2 microglobulin) amyloid. One hundred and ninety two patients with amyloidosis were followed for six months to eight years. Results-Hepatic amyloid was found in 98/180 (54%) AL and 25/138 (18%) AA patients but in only 1/53 patients with familial transthyretin amyloid polyneuropathy and in none with dialysis related amyloidosis. There was complete concordance between hepatic SAP scintigraphy and the presence or absence of parenchymal amyloid deposits on liver histology. Amyloidosis was never confined to the liver. Mortality was rarely due to hepatic failure, although hepatic involvement with AA amyloid carried a poor prognosis. Successful therapy to reduce the supply of amyloid fibril protein precursors was followed by substantial regression of all types of amyloid. Conclusions-SAP scintigraphy is a specific and sensitive method for detecting and monitoring hepatic amyloid. Liver involvement is always associated with major amyloid in other organ systems and carries a poor prognosis in AA type. Appropriate therapy may substantially improve prognosis in many patients. (Gut 1998;42:727-734)

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Section: Discussionmentioning

confidence: 99%

The liver in systemic amyloidosis: insights from ¹²³I serum amyloid P component scintigraphy in 484 patients

Lovat

Persey

Madhoo

et al. 1998

Gut

110

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“…The association between hepatic and/or systemic amyloidosis and hepatocellular adenomas has been rarely re-ported. [16][17][18][19] Unfortunately, these cases were published prior to the classification of HCA, 20 limiting comparison with the current case. The present case highlights the synchronous manifestation of three diseases potentially related to IL-6 overproduction by CD and/or IL-6/STAT3 pathway dysfunction.…”

Section: Discussionmentioning

confidence: 89%

Synchronous Unicentric Castleman Disease and Inflammatory Hepatocellular Adenoma: a Case Report

Vito

Pedica

et al. 2018

Annals of Hepatology

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Systemic symptoms such as fever and fatigue are non-specific manifestations spanning from inflammation to neoplasia. Here we report the case of a 34 year-old man who presented with systemic symptoms for four months. CT-scan and MRI revealed a 3.4 cm arterialized hepatic lesion and a 7 cm paraduodenal mass. Surgical resection of both lesions and histological examination revealed an inflammatory hepatocellular adenoma and a unicentric plasma cell type of Castleman disease. Moreover, a diffuse AA amyloid deposition in the liver was observed. Resection of both lesions was associated with an improvement of the symptoms. To our knowledge, this is the first report of a synchronous presentation of a unicentric plasma cell type of Castleman disease, inflammatory hepatocellular adenoma and AA amyloidosis.

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“…Systemic AA amyloidosis is a rare complication of HA which causes nephrotic syndrome with deteriorating renal function. Resection of the tumor is followed by improvement in renal function and a marked decrease of the serum concentrations of acute phase proteins [23].…”

Section: Pathologymentioning

confidence: 99%

Challenging Issues in Hepatic Adenoma

Boeți¹,

Tivadar²,

Lupescu³

et al. 2019

Liver Disease and Surgery [Working Title]

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Hepatic adenoma is known as a benign lesion encountered mainly in female patients and classically linked to the administration of oral contraceptives. In the last decade, the risk factors for its occurrence have changed and so did the sex ratio. The histopathological classification of hepatic adenomas was found to be related with certain genetic mutations that determine the risk for malignancy. The diagnosis of hepatic tumor is correlated with clinical and imaging data in an effort not only to rule out other tumors but also to distinguish the subtype of adenoma, which is very important for the management of the patient. The ultimate diagnosis is established by pathologists by routine histopathological and specific immunohistochemical staining. There are two major issues that pathologists need to recognize: the presence of β-catenin gene mutation and/or malignant degeneration. The best imaging examination is considered to be MRI. However, along with MRI, ultrasound and computer tomography have proved themselves to be effective not only in evaluating the number, size, localization, and complications of hepatic adenomas, but also in identifying their subtype. A detailed presentation of characteristics of all groups of hepatic adenoma is provided. The means of management of hepatic adenomas are documented and decisional algorithm is explained, based on certain criteria.

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Systemic AA amyloidosis induced by liver cell adenoma.

Cited by 20 publications

References 12 publications

The liver in systemic amyloidosis: insights from ¹²³I serum amyloid P component scintigraphy in 484 patients

The liver in systemic amyloidosis: insights from ¹²³I serum amyloid P component scintigraphy in 484 patients

Synchronous Unicentric Castleman Disease and Inflammatory Hepatocellular Adenoma: a Case Report

Challenging Issues in Hepatic Adenoma

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Systemic AA amyloidosis induced by liver cell adenoma.

Cited by 20 publications

References 12 publications

The liver in systemic amyloidosis: insights from 123I serum amyloid P component scintigraphy in 484 patients

The liver in systemic amyloidosis: insights from 123I serum amyloid P component scintigraphy in 484 patients

Synchronous Unicentric Castleman Disease and Inflammatory Hepatocellular Adenoma: a Case Report

Challenging Issues in Hepatic Adenoma

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Product

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The liver in systemic amyloidosis: insights from ¹²³I serum amyloid P component scintigraphy in 484 patients

The liver in systemic amyloidosis: insights from ¹²³I serum amyloid P component scintigraphy in 484 patients