| Popis: |
A case of erythroderma developed after hepatectomy for metastatic hepatic carcinoma is reported. The case was a 40-year-old male who underwent right partial lobectomy for matastasis to the liver from sigmoid colon carcinoma. During surgery 400 ml of fresh blood was transfused. Postoperative course was uneventful. On the 13th day after operation, however, the patient had an attack of high fever, and erythroderma developed on the next day. After that impaired liver function, diarrhea, melena, and pancytopenia followed. Terminally the patient lapsed into septisemia and died on the 31st postoperative day.Pathohistological findings were: 1) As to the skin, a liquefaction degeneration in the basal cells was found but no necrosis of eosinophilic leukocytes nor intraepidermal infiltration in lymphocytes was seen; 2) In the liver, there were an infiltration into monocytes in the portal venous region and degeneration of intrahepatic biliary epithelium; 3) The digestive tract presented a necrotized mucous membrane, pseudomembranous enterocolitis-like findings, and remarkable candidiasis. Though the histological findings of the skin did not offer complete informations, we considered that this erythroderma was possibly caused by the graft versus host reaction due to fresh blood transfusion at surgery. When fresh blood is used for hepatectomy, irradiation to it should be mandatory. |
