tailieunhanh - Ebook Gastrointestinal imaging: Part 2

(BQ) Part 2 book "Gastrointestinal imaging" presents the following contents: Focal liver disease, gallbladder, pancreas, bile ducts, spleen, multisystem disorders and syndromes, peritoneum, mesentery and abdominal wall. | Section VIII Focal Liver Disease CHAPTER 60 Cystic Hepatic Tumors Jin-Young Choi Guilherme Moura da Cunha Beatriz C. Baranski Kaniak and Claude B. Sirlin A. Simple Hepatic Cysts and Polycystic Liver Disease well-defined cysts are present usually in both lobes of the liver. These cysts are histologically identical to hepatic cysts and their pathogenesis is thought to be similar. Definition Simple hepatic cysts are benign developmental epithelium-lined lesions that contain serous fluid and do not communicate with the biliary system. Autosomal dominant polycystic liver disease is an inherited disorder characterized by cyst formation in several organs including the liver. Demographic and Clinical Features Simple hepatic cysts are present in at least of adults and are more frequent in women. They are usually detected incidentally. Hepatic cysts can be solitary or multiple. Over 90 are asymptomatic rarely symptoms may arise owing to compression of bile ducts or other adjacent structures. Most hepatic cysts are sporadic but can also occur in association with autosomal dominant AD polycystic hepatorenal disease. About 40 of patients with AD polycystic hepatorenal disease with renal involvement have hepatic cysts 15 of affected patients have multiple hepatic cysts but no radiographically identifiable renal cysts. AD polycystic liver disease is usually asymptomatic. Rarely advanced disease manifests with painful hepatomegaly abdominal protuberance and discomfort hepatic dysfunction compromised pulmonary function from diaphragmatic compression and as a result of vascular compression pre-sinusoidal portal hypertension or Budd-Chiari syndrome. Pathology Histologically hepatic cysts are lined with a single layer of cuboidal epithelium identical to that of bile ducts and a thin rim of fibrous stroma. Although the pathogenesis of hepatic cysts is not known it is believed that they are congenital developmental in origin resulting from progressive dilation of biliary .

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