Hepatic solitary

Autonomic outputs. Hypoglycaemia and hypothermia both lead to snstained sympathetic responses. Subjects feel hungry and eat if possible, bnt they refine their other actions to suit the circumstances. Hypoglycaemia requires hepatic glycogenolysis and glnconeogenesis, while hypothermia requires increased heat prodnction and a redistribntion of blood flow. Sympathetic activity is controlled by the hypothalamns, which instrncts the adrenal medulla to secrete adrenalin. This is a rather blunt control, and so localised sympathetic responses (such as blood flow regulation) are mediated by individnal nerves. Parasympathetic activity can also respond to the hypothalamus, which controls the nnclens of the solitary tract. 

Rubin, R.A., Lichtenstein, G.R. Hepatic scintigraphy in the evaluation of solitary solid liver masses. J. Nucl. Med. 1993 34 697-705... 

Monteagndo, M., Vidal, G., Moreno, M., Bella, R., Diaz, M.J., Col-omer, O., Santesmasses, A. Squamous cell carcinoma and infection in a solitary hepatic cyst. Eur. J. Gastroenterol. Hepatol. 1998 10 1051-1053... 

Solitary fibrous tumor, synovial sarcoma, hepatic adenoma, neuroendocrine carcinoma, GIT adenocarcinomas, endometrioid carcinoma, cholangiocellular carcinoma... 

Hepatic adenomas are reported to be solitary in 70-80% of cases, but it is not unusual to encounter two or three adenomas in one patient. Adenomas are usually well-circumscribed lesions, varying in size from less than 1 cm to more than 15 cm. The typical steroid-related adenoma often comes to clinical attention when it reaches about 5 cm in diameter. Histologically, hepatic adenoma is defined as a tumor composed of cells closely resembling normal hepa-tocytes, but larger than normal liver cells, the cytoplasm containing variable amounts of glycogen and lipid a typical yellow appearance of the cut surface of the tumor is related to lipid accumulation. 

The hepatic mass is commonly a large, lohulated and encapsulated solitary mass necrosis and hy-pervascnlarity are prominent features. Vascular and biliary invasion are common. HCC had heen reported as well-differentiated in 15% of patients, moderately differentiated in 82%, and poorly-differentiated in 3% of cases (Brancatelli et al. 2002). 

Grossly, the appearance of primary hepatic lymphoma is variable. There is a large solitary mass with central fibrosis or necrosis. Moreover, multiple smaller nodular lesions are depicted. Furthermore diffuse forms of hepatic lymphoma are seen, documenting hepatomegaly without discrete lesions. 

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