Diagnostics of nodular lesions in abdominal cavity accidentally found during routine USG examination

Marek Chorazy
Department of Clinical Oncology and Internal Medicine, St.Leszczynski Hospital Raciborska 27. 40-074 Katowice Poland

Abstract:

Introduction:
In the clinical assessment of tuberous lesions in abdominal cavity, we try to determine their size, output point and type of histopathological texture. Focal tuberous lesions in inner organs appear mostly in liver, pancreas, kidneys. The character of solid lesions can be determined by biopsy, in case of  cystomatous lesions, the examination of their contents helps us to identify them. Ultrasound (US) examination is more and more frequent procedure in patients admitted to hospital. Its main function is to confirm or exclude the reasons of patient’s ailments. During such examination, some pathological focuses in abdominal cavity are disconnected to the illness the patient was admitted to the hospital. That is why the authors, decided to trace the number of solid focal lesions which are accidentally found in US scanning, the organs they refer to and the results of histopathological examinations. In the available literature we have not found before such research.

Material and methods:
Presented results of biopsy diagnostics refer to years 1996 - 2008.  In this time 1484 biopsy examinations of tuberous lesions in the abdominal cavity have been done by US equipment: EG Logic C 5 and HITACHI EUB 515. All examinations have been done in US laboratory at Department of Clinical Oncology and Internal Medicine of.  St. Leszczynski Hospital in Katowice. From the group of 1484 patients was isolated a group of 42 patients where focal lesions have been found accidentally during routine examination without clinical symptoms.

Study results:
In case of 1484 patients qualified for target biopsy under US control, 42 cases were the lesions which required histopathological verification, which  were found accidentally  during routine US examination. Such lesions were found only in 2 organs – liver and kidney. Number of focal lesions accidentally found in liver were 30 which is 2,57% of all focal changes verified by biopsy. In this material, only in 1 case (3,3%)  the lesion was malignant (fig 1). The histopological analysis done for kidneys looks quite different. Here, among 160 cases of biopsy, 12 (7,5%) found lesions accidentally. But in case of 11 patients (91,7%) the hyperplasia had a neoplastic character (fig 2).

Conclusions:
1. Ultrasonography of abdominal cavity should be done in case of every hospitalized patient as it gives the opportunity to find changes which do not give clinical symptoms.
2. During routine examination, we frequently diagnose focal lesions in liver, kidneys. The character of accidentally found lesions in liver is usually benign, on the other hand the