Hyperenhanced Rim Surrounding Liver Metastatic Tumors in the Postvascular Phase of Sonazoid-Enhanced Ultrasonography: A Histological Indication of the Presence of Kupffer Cells

• Published in: Oncology Vol. 89; no. Suppl 2; pp. 33 - 41
• Main Authors: Tochio, Hitoshi, Sugahara, Masafumi, Imai, Yukihiro, Tei, Hiroshi, Suginoshita, Yoshiyuki, Imawsaki, Nobuhiro, Sasaki, Ichiro, Hamada, Michio, Minowa, Kazushi, Inokuma, Tetsuo, Kudo, Masatoshi
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.11.2015
• Subjects: Adult; Aged; Aged, 80 and over; Cancer therapies; Care and treatment; Clinical Study; Contrast Media - pharmacokinetics; Diagnosis; Female; Ferric Compounds - pharmacokinetics; Follow-Up Studies; Health aspects; Humans; Image Enhancement - methods; Iron - pharmacokinetics; Kupffer Cells - diagnostic imaging; Kupffer Cells - metabolism; Kupffer Cells - pathology; Liver cancer; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - metabolism; Liver Neoplasms - secondary; Liver tumors; Male; Metastasis; Middle Aged; Neoplasm Staging; Oncology; Oxides - pharmacokinetics; Prognosis; Tissue Distribution; Ultrasonic imaging; Ultrasonography; Ultrasound imaging; Japan; Programmed cell death-1 antibody; Liver cancer; Kupffer cell; Sonazoid; Contrast-enhanced ultrasonography; CD8-positive T cell
• ISBN: 3318056286; 9783318056280
• ISSN: 0030-2414; 1423-0232; 1423-0232
• DOI: 10.1159/000440629

Aim: A hyperenhanced rim (termed ‘HER') in the postvascular phase is detected in some cases of liver metastasis by Sonazoid-enhanced ultrasonography (US). Here, the association of the HER with histological features was investigated to clarify the cause of this characteristic imaging pattern. Subjects and Methods: A total of 13 hepatic nodules obtained from 11 patients with metastatic liver cancer who underwent Sonazoid-enhanced US followed by surgical resection were analyzed. The distribution density of CD68-positive cells in the tumor rim and the nontumor area was calculated and compared between the HER-positive and HER-negative groups. The relation between the pathological features of the tumor rim and the rate of necrosis within the tumor was also investigated. Results: In the HER-positive group (n = 8), the distribution density of CD68-positive cells was 2.9 ± 0.9, which was significantly higher than that (1.0 ± 0.3) in the HER-negative group (p < 0.05). Inflammatory cell infiltrates, including CD8-positive lymphocytes, were detected in all the HER-positive cases in the area surrounding the tumor, while fibrosis was observed in all the HER-negative cases. The necrotic area within the tumor was significantly larger in the HER-negative group. Conclusion: The HER-positive sign in liver metastases could reflect an increase in Kupffer cells in the tumor rim. The presence of the HER was associated with inflammatory cell infiltrates including CD8-positive lymphocytes surrounding the metastatic liver tumor.