Tamoxifen-induced non-alcoholic steatohepatitis in patients with breast cancer: determination of a suitable biopsy site for diagnosis.
We have evaluated the distribution of fatty infiltration in the liver for determination of a suitable biopsy site for diagnosis of tamoxifen-induced non-alcoholic steatohepatitis (NASH) in patients with breast cancer. Thirty-eight consecutive breast cancer patients undergoing tamoxifen treatment were analyzed by CT to identify hepatic steatosis (HS) via calculation of the liver/spleen CT ratio in Couinaud's 8 areas. We defined hepatic fatty infiltration as a liver/spleen ratio of less than 0.9. The extent and distribution of the fatty infiltration was assessed using the liver/spleen ratio of the patients who had the lowest CT ratio below 0.9 in the 8 areas. Thirteen (34.2%) of the 38 patients had hepatic fatty infiltration. The liver/spleen ratios of each area differed significantly in all patients (p<0.0001). The CT ratio of these 13 patients was significantly lower in the right lobe than the left lobe (p<0.0001), although the ratios did not differ significantly among the 4 areas of the right lobe (p=0.52). Needle biopsy for diagnosis of NASH should be performed at the right lobe, which contains significantly more infiltrated fat than the left lobe in the liver.
Murata
Yoriko
Y
Department of Radiology, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Japan. muratay@kochi-ms.ac.jp
Ogawa
Yasuhiro
Y
Saibara
Toshiji
T
Nishioka
Akihito
A
Takeuchi
Naoko
N
Kariya
Shinji
S
Onishi
Saburo
S
Yoshida
Shoji
S
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001707:Biopsy, Needle / Q000379:methods; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D056486:Chemical and Drug Induced Liver Injury / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies; D013154:Spleen / Q000000981:diagnostic imaging; D013629:Tamoxifen / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen; D005472:Fluorouracil