Immune checkpoint inhibitors and the liver: balancing therapeutic benefit and adverse events.

Immune checkpoint inhibitors (ICI) have led to breakthrough improvements in the management of malignancy including hepatocellular (HCC) and biliary tract cancer, improving decades-old standards of care and increasing patient survival. In both liver tumour types, which commonly arise in the context of liver inflammation and underlying functional impairment, the lack of validated predictors of response underscores the need to balance predicted gains in survival with risk of treatment-related hepatoxicity and decompensation of underlying chronic liver disease.In addition, the liver is implicated in the toxicity associated with ICI therapy for non-liver cancers, which exhibits a high degree of variability in presentation and severity.

Caesarean section scar: Histological analysis on hysterectomy specimen. A pilot study.

Introduction: In recent years, caesarean section (CS) rate has risen worldwide. Complications associated with CS scars have risen too, such as scar dehiscences and uterine ruptures. Uterine healing is a complex phenomenon still poorly understood.

Primary liver cancer classification from routine tumour biopsy using weakly supervised deep learning.

Background & Aims: The diagnosis of primary liver cancers (PLCs) can be challenging, especially on biopsies and for combined hepatocellular-cholangiocarcinoma (cHCC-CCA). We automatically classified PLCs on routine-stained biopsies using a weakly supervised learning method.

Method: We selected 166 PLC biopsies divided into training, internal and external validation sets: 90, 29 and 47 samples, respectively.

Urgent Liver Transplantation for Acute Liver Failure in Pregnant Women: The Optimum Timing for Delivery.

Background: The occurrence of acute liver failure (ALF) in pregnant women due to an etiology unrelated to pregnancy (pregALF) that leads to liver transplantation (LT) has rarely been reported. The objective was to report the outcome of pregnant women and fetus and propose a strategy for the timing of delivery and of LT in these patients.

Methods: Five consecutive pregnant patients with ALF were admitted to our center between 1986 and 2018 and underwent an LT.

Evaluation of perfusion CT and dual-energy CT for predicting microvascular invasion of hepatocellular carcinoma.

Purpose: Evaluation of perfusion CT and dual-energy CT (DECT) quantitative parameters for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC) prior to surgery.

Methods: This prospective single-center study included fifty-six patients (44 men; median age 67; range 31-84) who provided written informed consent. Inclusion criteria were (1) treatment-naïve patients with a diagnosis of HCC, (2) an indication for hepatic resection, and (3) available arterial DECT phase and perfusion CT (GE revolution HD-GSI).

Four-Year Experience of Digital Slide Telepathology for Intraoperative Frozen Section Consultations in a Two-Site French Academic Department of Pathology.

Objectives: To share our experience with digital slide telepathology for intraoperative frozen section consultations (IOCs) and to describe its evolution over time by reporting performance metrics and addressing organizational and economic aspects.

Methods: Since 2013, a technician has been alone at the surgical site. At the other site, the pathologist opens the digital slide from a local server via the intranet.

Liver transplantation in patients with liver failure related to exertional heatstroke.

Background & Aims: Severe acute liver injury is a grave complication of exertional heatstroke. Liver transplantation (LT) may be a therapeutic option, but the criteria for LT and the optimal timing of LT have not been clearly established. The aim of this study was to define the profile of patients who require transplantation in this context.

18F-FDG Uptake in Well-Differentiated Neuroendocrine Tumors Correlates with Both Ki-67 and VHL Pathway Inactivation.

Background: 18F-FDG-PET scan positivity correlates with poor prognosis in neuroendocrine neoplasms (NEN). Glucose transporter 1 (GLUT1) and carbonic anhydrase 9 (CA9) are markers of aggressiveness in tumors. Together with von Hippel-Lindau protein (pVHL), they are involved in tumor cell metabolism via the hypoxia-inducible factor signaling pathway.

[F]FDG PET/CT predicts progression-free survival in patients with idiopathic pulmonary fibrosis.

Background: Idiopathic pulmonary fibrosis (IPF) is a devastating disease characterized by an unpredictable course. Prognostic markers and disease activity markers are needed. The purpose of this single-center retrospective study was to evaluate the prognostic value of lung fluorodeoxyglucose ([F]-FDG) uptake assessed by standardized uptake value (SUV), metabolic lung volume (MLV) and total lesion glycolysis (TLG) in patients with IPF.

Acute Liver Failure/Injury Related to Drug Reaction With Eosinophilia and Systemic Symptoms: Outcomes and Prognostic Factors.

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare severe adverse drug-induced reaction with multiorgan involvement. The outcome and prediction of those patients who develop severe acute liver injury (sALI) or acute liver failure (ALF) remain little known.

Methods: A multicenter retrospective study of patients admitted with a diagnosis of DRESS-related sALI or ALF.