Systematic Reviews
Copyright ©The Author(s) 2019.
World J Clin Cases. Sep 26, 2019; 7(18): 2746-2759
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2746
Table 1 Quality assessment of 11 case reports
Case No.AuthorsDemographic dataClinical symptom datalaboratory examination dataDiagnostic workupImaging findings
1Hu et al[17]*********
2Kang et al[18]**********
3Yan[20]*********
4Yoneda et al[21]*******
5Kawa et al[31]*********
6Mortelé et al[8]*********
7van den Bosch et al[13]**********
8Marasco et al[9]*******
9Liu et al[32]********
10Choi et al[28]*********
11Arakawa et al[29]*********
Table 2 Quality assessment of 18 case series
Case No.AuthorsPatients enrollmentDemographic dataClinical symptom dataLaboratory examination dataDiagnostic workupImaging findings
1Chen et al[33]*********
2Xu[34]*********
3Ye et al[35]**********
4Zheng et al[36]********
5Ren et al[37]***********
6Geng et al[38]********
7Chen et al[39]*********
8Zhang et al[40]*********
9Li et al[41]**********
10Hu et al[42]********
11Li et al[43]********
12Li et al[44]*********
13Yu et al[24]********
14Rong[45]*********
15Pei et al[46]*********
16Zhou et al[47]*********
17Guo[48]********
18Yang[49]**********
Table 3 Characteristic information of patients in 11 case reports
No.AuthorsCountryPublication yearPatient No.Sex (male/fe-male)Age (average)Primary diseaseEtiologyTime of durationDiagnostic method
1Hu et al[17]China20142(2/0)71/63/TusanqiUKClinical manifesta-tions + laboratory examination + imaging
2Kang et al[18]China20151Female62/TusanqiUKBiopsy
3Yan[20]China20151Male65Liver cirrhosisTusanqi (300g)UKClinical manifesta-tions + laboratory examination + imaging
4Yoneda et al[21]Japan20151Female75Hepatic metastasis of colonic carcinomaPreoperative chemotherapy (Pmab + m-FOLFOX6)6 cycles (preoperative) + 4.5 month (postopera-tive)Biopsy
5Kawa et al[31]Japan20161Female40Rectal cancer underwent high anterior resection and partial liver resection due to liver metastasisOxaliplatin-based chemo-therapy (mFOLFOX6)6 moBiopsy
6Mortelé et al[8]USA20011Male32/“Poppers”, a recreational drug used during anal intercourseUKBiopsy
7van den Bosch et al[13]Netherlands19992(1/1)17/34Lymph-ocytic leukemia/acute myeloid leukemiaBone marrow transplanta-tionUKPercuta-neous puncture + histological examination/autopsy
8Marasco et al[9]UK20161Male50Ulcerative colitis6-thioguanineUKClinical manifesta-tions + imaging
9Liu et al[32]China20171Male52Gastric adenocarcinomaS-1 and oxaliplatine (SOX) regimenFive cyclesBiopsy
10Choi et al[28]Korea20161Female22Laparo-scopic right hemicolectomy for ascending colon cancerOxaliplatin-based adjuvant chemo-therapyFour cyclesBiopsy
11Arakawa et al[29]Japan20131Female40Low anterior resection for advanced rectal cancerOxaliplatin-based chemo-therapyEight cyclesBiopsy
Table 4 Characteristic information of patients in 18 case series
No.AuthorsCountryPublication yearPatient enroll-mentPatient No.Year rangeSex (male/fe-male)Age (range, average)Primary diseaseEtiologyTime of durationDia-gnostic method
1Chen et al[33]China2016Retro-spective82006-20135/321-67, 42/Tusanqi3-18 moBiopsy (5) Clinical manifesta-tions + imaging (3)
2Xu[34]China2015Retro-spective112004-20129/237-65, 49/Tusanqi (350-800 g)15-50 dBiopsy (2) Clinical manifesta-tions + imaging (9)
3Ye et al[35]China2015Retro-spective202010-20121/1936-76, 51Trauma or strokeTusanqi10 d-6 moBiopsy (12) Clinical manifesta-tions + laboratory examina-tion + imaging (8)
4Zheng et al[36]China2015Retro-spective42012-20144/045-66Alcoholic liver cirrhosis, trauma, body painTusanqi (600-1500 g)1-4 moClinical manifesta-tions + imaging
5Ren et al[37]China2017Retro-spective2392010-2017151/8815-86 (59.6 ± 10.9)Trauma, hypertension, extravasated blood, URITusanqiUKBiopsy (48), Clinical manifesta-tions + imaging
6Geng et al[38]China2009Retro-spective42007-20081/342-72, 57/Tusanqi12-60 dClinical manifesta-tions
7Chen et al[39]China2012Retro-spective451998-201123/2233-73, 57TraumaTusanqi2-16 wkBiopsy (21) Clinical manifesta-tions + laboratory examina-tion + imaging (8)
8Zhang et al[40]China2012Retro-spective152005-201112/342-65/Tusanqi1-6 moBiopsy (6) DSA (1) Clinical manifesta-tions + laboratory examina-tion + MRI
9Li et al[41]China2011Retro-spective42009-20112/227-63, 35/Tusanqi (3), chemo-therapy (1)Tusanqi (1-3 mo)Biopsy (2) Clinical manifesta-tions + imaging
10Hu et al[42]China2011Retro-spective52006-20114/140-60Trauma history (3), health fitness (1)Tusanqi≥1 moBiopsy (2) Clinical manifesta-tions + imaging
11Li et al[43]China2015Retro-spective42009-20143/135-61Myocar-dial infarction (1)Tusanqi/UK
12Li et al[44]China2014Retro-spective82011-20145/321-71, 44.9/Tusanqi (2) Chemo-therapy or immune suppres-sive therapy (9)/Biopsy
13Yu et al[24]China2013Retro-spective62002-20121/510-62 (36.5 ± 20.2)Trauma (5) Irregular menstrua-tion (1)Tusanqi (200-700 g)8-30 dBiopsy
14Rong[45]China2015Retro-spective512009-201536/1520-79Drinking (14) Hyperten-sion (1) Diabetes (1) TB (1) RA (1)Tusanqi (27) HSCT (4),3 d-4 yrBiopsy (6) Clinical manifesta-tions + imaging
15Pei et al[46]China2010Retro-spective62006-20082/417-46/Tusanqi (5)30 dBiopsy (3) Clinical manifesta-tions + imaging
16Zhou et al[47]Hong Kong, China2014Retro-spective162009-201112/422-72, 55.6/Intake of Gynura segetumUKLiver transplanta-tion (1) Clinical manifesta-tions
17Guo[48]China2015Retro-spective122013-20149/345-62, 53/TusanqiUKClinical manifesta-tions + imaging
18Yang[49]China2018Retro-spective392010-20169/3036-74, 59.18 ± 9.36/Pyrrolizi-dine alkaloid (PA)–containing herbalsUKClinical manifesta-tions + imaging
Table 5 Clinical characteristics of 13 patients in 11 case reports, n (%)
VariableNo. of patients with available dataValue
Sex (male/female)137/6
Age, yr1347.9
Underlying disease
None134 (30.8)
Postoperative liver metastasis of advanced colorectal cancer133 (23.1)
Leukemia132 (15.4)
Liver cirrhosis131 (7.7)
Hepatic metastasis of colonic carcinoma131 (7.7)
Gastric adenocarcinoma131 (7.7)
Clinical symptom
Ascites137 (53.8)
Abdominal swelling134 (30.8)
Pleural effusion134 (30.8)
Hepatomegaly133 (23.1)
Jaundice133 (23.1)
Stomach ache133 (23.1)
Weak133 (23.1)
Lower limbs edema132 (15.4)
Lower limbs lassitude132 (15.4)
Loss of appetite132 (15.4)
Yellow urine132 (15.4)
Oliguria131 (7.7)
Esophageal varices131 (7.7)
PVH131 (7.7)
Etiology
Chemotherapy135 (38.5)
Tusanqi134 (30.8)
Hematopoietic stem cell transplantation132 (15.4)
“Poppers,” a recreational drug used during anal intercourse131 (7.7)
Drug toxicity (6-thioguanine)131 (7.7)
Laboratory index
ALP, U/L11206.4
ALT, U/L9836.2
AST, U/L81284.25
GGT, U/L7155.42
LDH, U/L35608.33
TBil, μmol/L963.11
DBil, μmol/L535
Alb, g/L537.52
TBA, g/L227.65
T-CHE, U/L23242
TP, g/L147.7
CA-125, U/mL1299.1
Table 6 Magnetic resonance imaging features of all 256 examinations, n (%)
MRI featureNumber of cases
Heterogeneous signals on T1WI/T2WI221 (86.3)
Heterogeneous enhancement189 (73.8)
Ascites189 (73.8)
Hepatomegaly167 (65.2)
Narrowing and blurring of intrahepatic IVC167 (56.6)
Gallbladder wall edema121 (47.3)
Narrowing of three main hepatic veins105 (41.1)
Edema around the portal vein, "cuffing"90 (35.2)
Narrowing and blurring of intrahepatic veins52 (20.3)
Collateral circulation opens37 (14.6)
Splenomegaly32 (12.5)
Narrowing and blurring of portal vein28 (10.9)
Dilated and twisted small vessels17 (6.6)
Hypo-intensity on HBP17 (6.6)
Dilated hepatic arteries12 (4.7)
"Halo signs" around the hepatic vein and intrahepatic IVC11 (4.3)
Restricted diffusion5 (2.0)
Gastrointestinal edema4 (1.6)
Multiple hyperplasia nodules2 (0.8)
Caudate lobe enlargement2 (0.8)
Focal nodules or masses1 (0.4)
Dilated spleen vein1 (0.4)