Histopathologic Patters of liver Diseases: a Five Year Retrospective Study in Tertiary Level Teaching Hospital, Tikur Anbessa Specialized Hospital, Ethiopia.
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Date
2020-12
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Addis Ababa University
Abstract
Introduction: Liver diseases account for a significant number of morbidity and mortality worldwide being affected by a wide spectrum of various primary and secondary diseases. The major primary diseases of the liver are viral hepatitis, nonalcoholic fatty liver disease (NAFLD), alcoholic liver disease, and hepatocellular carcinoma (HCC). Distinguishing among them can be challenging, but the distinction is critically important given the differing prognostic and therapeutic implications. These diseases can be diagnosed with the help of clinical, biochemical or radiological examinations. However, liver histopathology remains the mainstay in diagnosis as well as management of various liver diseases.
Objectives: The aim of this study was to assess histopathologic patterns of liver diseases
Methods and Materials: A retrospective descriptive histopathological analysis of histopathological pattern of liver disease was carried out in the Postgraduate Department of Pathology, college of health sciences, Tikur Anbessa Specialized Referral Hospital (TAH), Addis Ababa, Ethiopia. Patients data was retrieved from the archives of the department of Pathology for a period of 4 years and 8 months from January 2016 to August 2020).
Result : In this study a total of 116 cases were included. Of the total cases 60(51.7%) were females and 56(48.3%) were males with female to male ratio of 1.1:1. Most of the ages ranges from 30 to 79 years, which accounts for 86.2% of cases and with mean, standard deviation, lowest and highest
age range of 49, 17.97, 6 months and 79 years respectively. The peak age was the 7 decade. Malignant lesions were the most common diagnoses accounted for 56.9%, HCC being the most frequent malignant lesion 19.8% of all cases followed by secondary carcinoma 17.2%, cholangiocarcinoma 6.9%, neuroendocrine tumor 3.4%, secondary high grade sarcoma 2.6%, adenocarcinoma with neuroendocrine differentiation 1.7%, hepatoblastoma 1.7%, malignant undifferentiated tumor 0.9 %, lymphoma 0.9%, secondary epitheloid GIST 0.9% and suspicious for malignancy 0.9% in decreasing frequency. HCC was more common in males with male to female ratio of 2.8 : 1. Almost all benign liver lesions were found in females with female to male ratio of 12 : 1. Hemangioma was the most common benign neoplastic lesion accounting for 7.8% followed by benign liver cyst 1.7% and FNH 0.95%. TB was most common non neoplastic lesion 3.4%. And the remaining histologic patterns included hydatid cyst 3(2.6%), abscess 2(1.7%), seatosis/fatty change 2(1.7%), cirrhosis 1(0.9%), biliary atresia with cirrhosis 1(0.9 %),
chronic active hepatitis 1(0.9%), acute alcoholic hepatitis 1(0.9%), acute complete intrahepatic cholestasis with ascending cholangitis + stage 3 fibrosis 1(0.9%), chronic nonspecific inflammation of the cyst wall 1(0.9%), non diagnostic 1( 0.9%) and 3(2.6%) of cases were reported as normal histology. 13.8% of cases were descriptive reports.
Conclusion : HCC is the most common liver lesion and most common malignant histopathologic diagnosis in this study which agrees to some studies in India. In most African studies infectious and inflammatory lesions are the most common. The diagnoses of malignant lesions in this study were at later ages than most of other studies. Hemangioma was significant in amount.
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Keywords
HCC, malignant lesions, infectious and inflammatory lesions, hemangioma.