Wednesday, May 26, 2010

Cut It Out

You are the pathologist receiving this specimen from the operating room. This patient had encephalopathy, GI bleed, weight loss, and early satiety. Labs show thrombocytopenia, hypoalbuminemia, hyperbilirubinemia, and prolonged PT and PTT. AST, ALT, alkaline phosphatase, and gammaglutamyl transpeptidase are all elevated. A chart biopsy shows that these abnormalities have been going on for years.

Challenge: What serum marker is often elevated in this disease?

Image shown under Fair Use.


Suheil said...

Alpha Feto Protein?

Craig Chen said...

Cut It Out

This is a hepatocellular carcinoma which develops in the setting of chronic liver disease such as viral hepatitis. Symptoms are usually due to underlying liver disease. AFP is often elevated.

Source: UpToDate, image originally from Richard Freeman.