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Classification of Shi et al for Malignant Thrombus in the Portal Vein Associated with Hepatocellular Carcinoma

Description

Shi et al reported a classification for malignant thrombus in the portal vein associated with a hepatocellular carcinoma. The presence of macroscopic tumor thrombus in the portal vein is a poor prognostic finding. The authors are from the Chinese University of Hong Kong.


Patient selection: hepatocellular carcinoma

 

Tumor Extent

Type

microscopic invasion of the vein

I(0)

intrahepatic (segmental branches or above)

I

left or right portal vein

II

main trunk of the portal vein

III

superior mesenteric vein

IV

 

where:

• Extension could also occur into the splenic vein.

• Classifications of portal vein thrombosis include a diffuse category with involvement of the superior mesenteric, inferior mesenteric and splenic veins.

 

Differential diagnosis:

(1) nonmalignant portal vein thrombosis (can be mixed)


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