Hepatobiliary Flashcards
Fleming et al. 2019. A randomised comparison of aspiration and non-aspiration fine needle technique for obtaining ultrasound-guided cytological samples from canine livers
Study compared aspiration and non-aspiration FNAs
119 dogs - FNA (41), FN-NA (65)
How may samples were diagnostic?
Prevalence of diagnostic samples for FNA and FN-NA?
Non-diagnostic samples were significantly associated with?
- 2%
- 5% and 94%
Low cellularity, poor cell preservation, severe hemodilution
FN-NA was superior to aspiration technique of canine liver - higher rates of diagnostic cytology samples, greater cellulary, and better cytology preservation
Leela-Arporn et al. 2019. Plasma-free amino acid profiles in dogs with HCC
Metabolomic analysis has been suggested for early detection of cancer.
34 dogs diagnosed with HCC (26), liver disease (8), and 11 healthy dogs
Glutamic acid concentrations?
PFAA profile?
Pre-oprative and post-operative PFAA with HCC?
Dogs with HCC and benign liver disease had significantly higher levels than healthy dogs
No significant difference in PFAA profiles of HCC and liver disease.
Pre-operative and post-operative PFAA of dogs with HCC were not different
Increased glutamic acid concentation may play a role in development or consequence of liver tumor formation. PFAA profiles are not useful biomarkers for detecting HCC in dogs.
Leela-Arporn et al. 2019. Predictive factors of malignany in dogs with focal liver lesions using clinical data and ultrasonographic features
Determine the diagnostic accuracy of clinical data and US features to differentiate benign and malignant liver lesions.
55 dogs with malignant lesions and 28 dogs with benign lesions
In the unviariate analysis, what factors were associated with malignancy?
In the multivariate analysis, what factors could differentiate between benign and malignant liver lesions?
US features and platelet count were associated with liver malignancy
Platelet count (thrombocytosis), lesion size (4.1 cm or greater), echotexture of focal liver lesions (heterogeneous) were independent predictors
Fukushima et al. 2012. CT characteristics of primary hepatic mass lesions in dogs
33 with HCC (14), hepatocellular adenoma (14) or nodular hyperplasia (5)
Common findings with HCC?
Hepatic adenoma?
Nodular hyperplasia?
Mass size?
Central (79%) and marginal enchancement (93%) in arterial phase, cyst-like lesions (93%), capsule fomration (93%), and hypoattenutation in the portal (86%) and equilibrium phases (93%)
Diffuse enhancement during aretrial phase (57%) which was also found in nodular hyperplasia (60%) - but not in HCC
Nodular hyperplasia less likely to have capsule structure (20%).
Mass size was significantly smaller in nodular hyperplasia than HCC and hepatic adenoma.
Hyperattenutation in the arterial phase and portal phase i.e. contrast retention more frquent in hepatic adenoma than other groups.
Nodular hyperplasia was isoattenuating.
Masserdotti et al. 2012. Retropsective study of cytologic features of well differentiated HCC in dogs
What were the most useful cytologic features in the diagnosis of canine well-differentiated HCC in dogs?
Dissociation of hepatocytes, acinar, or palisading arrangements of neoplastic cells and presence of naked nuclei and capillaries together with mild anisocytosis, anisokaryosis, multunuclearity, and increased N:C ratios
Murakami et al. 2012. Analysis of clinical and ultrasonographic data by use of logistic regression models for prediction of malignant versus benign causes of ultrasonographically detected focal liver lesions in dogs
247 dogs evaluated for US and histologic evaluation of the liver
Factors associated with malignant liver disease
Greater size lesions and presence of peritoneal fluid had positive associayed with malignant liver disease.
Keller et al. 2013. Hepatosplenic and hepatocytotropic T cell-lymphoma: two distinct types of T cell lymphoma in dogs
Clinical, clinipathologic findings of 9 dogd with T cell LSA that involved the liver in absence of peripheral lymphadenopathy were assessed.
Dogs with HS-TCL presented with what 5 signs?
How were the neoplastic cells arranges? Immunophenotype?
How were the 2 dogs different?
hepatomegaly, splenomegaly, regenerative anemia, thrombocytopenia, hypoproteinemia
Neoplastic cells were centered on hepatic and splenic sinusoids - CD3+ (5/7), TCRab (5/5), TCRgd (3/5), CD11d+ (6/7), granzyme B+ (5/7) immunophenotype
Not confined to hepatic sinusoids but inaved hepatic cords - CD11d- and had marked cholestasis and mild to absent anemia
The name hepatocytotropic is proposed
Warren-Smith et al. 2012. Lack of association between US appearance of parenchymal lesions of the canine liver and histologic diagnosis
Most prevalent US features
Multifocal lesions?
Diffuse lesions?
Hyperechoic lesions?
Heterogeneous lesions?
Target lesions were associated with malignancy in what %?
Multifocal lesions (63% HSA and 43% HCC)
Diffuse lesions (71% steroid hepatopathy, 44% fibrosis, 40% VH)
Hyperechoic lesions (71% SH, 41% lipidosis, 38% fibrosis)
Heterogenoeus lesions (62% HSA)
67%
No significant associated b/w US appearance and diagnosis
Elpiner et al. Single agent gemcitabine chemotherapy in dogs with HCC
18 dogs received gemcitabine 350-400 mg/m2 weekly for 5 weeks - 15 dogs completed the protocol
Toxicity?
MST?
Median PFI?
Minimal - grade I/II vomiting, anorexia, diarrhea, 2 episodes of grade III neutropenia
983 days (2.7 yr)
971 days (2.6 yr)
Sugery is the best option even with incomplete resection with no improvement in survival
Bahr et al. 2013. Accuracy of US-guided FNA of focal liver lesions in dogs: 140 cases (2005-2008)
Cytology had the highest sensitivity for?
Cytology had the highest PPV?
Cytology had lower sensitivity and PPV for?
Vacuolar change (60%) then neoplasia (52%)
Neoplasia (87%) then vacuolar change (51.6%)
Inflammation, necrosis, hyperplasia
High confience when neoplasia is diagnosed on cytology. Cytology is less reliable for exclusing neoplasia.
Iida et al. Itraoperative identification of canine HCC with indocyanine green fluorescent imaging
12 hepatic nodules were surgically resected from 6 dogs. 0.5 mg.kg dye was given IV 12-18 hours preop
6 were HCC and 6 were nodular hyperplasia
What was the sensitivity and PPV?
71.4% and 80%
May healp increase the chance of complete resection of HCC in dogs
Cortright et al, 2014. Clinical features of progressive vacuolar hepatopathy in Scottish Terriers with and without HCC: 114 cases (1980-2013)
How may dogs with VH had HCC?
How many with high copper concentrations had histologic features consistent with copper-associted hepatopathy?
Signs consistent with Cushings were noted in __%, definitive diagnosis was inconsisently confirmed?
High progresterone and androstenedione were noted in?
34% with VH had HCC
58% (15/26)
40%
88% and 80%
VH may be linked to adrenal steoidogenesis and a predisposition to HCC. US surveillance and biochemical analysis is recommened
Michishita et al. 2014. Identification of tumor-initiating cells in canine HCC cell line
What were the markers expressed?
Which cells acquired the enhanced self-renewal capacity, proliferative activity, and tumorgenicity?
Which marker is enriched for tumor initating cells?
high CD44 and CD29, moderate CD90, and low CD133, CD34, CD24, CD117, and CD13
CD90+CD44+ compared to CD90-CD44+
CD90
van Sprundel et al. 2014. Classification of primary hepatic tumors in cats.
Feline primary tumors (n=61) were examined histologically
Malignant hepatocellular tumors expressed?
HepPar1, MRP2, pCEA positive, negative for K19
Kutara et al. 2013. Triple-phase helical CT in dogs with hepatic masses
Most common CT findings with HCC?
Most common finding with nodular hyperplasia
Metastatic hepatic tumors?
Heterogeneous pattern with hyper-, iso- and hypoattenuation in both arterial and portal venous phase (85%)
Homogeneous pattern with hyper-, and isoenhancement in both portal venous and delayed phases (93%)
Homogeneous hypoenhancement pattern in both arterial and portal venous phase (89%)
Triple-phase CT is useful for differentiation of HCC, nodular hyperplasia, and hepatic metastatic tumors in dogs
