Questions in Vascular lesions of the liver, and some oustanding associations rising questions at CRBCM.

*Taking Oral Contraceptive is associated with Hepatic Adenoma.
*Association between chronic Hepatitis, Cirrhosis, and Hepatoma
*Association between Ulcerative Colitis with Primary biliary cholangitis and Cholangiocarcinoma
why Spider Angioma
why Palmar Erythema
why LDH is linked to Lymphoma
Does a patient with multiple large unresectable
 Angiosarcoma in the liver candidate for liver transplant if there is no evidence of Metastatsis!

Potential Genes to investigate in liver lesions of Vascular tone/component!

1.VEGF and its corollary the EGFR
yes Avastin works in Angiosarcoma of the liver, and these are vascular lesions. So these genes are in play!
2. VHL, HIF yes these lesions are vascular and hypoxia must be coming in,
3.Estrogen, yes remember the predominance in these lesion in women of child bearing age, and the fact that Oral contraceptive must be discontinued, and avoidance of pregnancy is advised.
4.Androgenic Receptor gene, yes user of Androgenic drugs are at increased risk of Adenoma
5. Wnt (yes the catenin are involved for cellular polarity to be alterated and hypertrophy to occur)
6.Insulin Receptor, There must be in intervention from these genes as most patients with these lesions are obese, with diabetes Mellitus or Glycogen storage disorder particularly type 1A and 3.
7"Irritation/Inflammation such as seen with Hemochromatosis and fibrosis point to hyperactivity of the NF-kB and cyclins (IL 1,6,23)
8. Src gene needs examination because of potential development of sarcomatous lesions.
9. Endothelial involvement gives it DIC propensity (Kasabach-Merritt syndrome) or is-it the ADAMS associated with Cyclines involvedin initiating DIC?

?ROS amplification here give it the Metastatic potentials

(to be continued)