485
KAZUISTIKY42522701004696138190209248289309356404
Liver4253370100314884119143
cirrhosis584337010030456994132171201216245
and84533701003471110
pregnancy:9713370100376196135173207245276313330
a1318337010033
case13683370100296593129
report15133370100245997136160189
and171933701003371110
review18453370100235894110145198
of205933701003858
literature2133337010015305792116151178216241275
E3018822701004177122
|325227010043
VNITŘNÍ4268043010746106127172220280301
LÉKAŘSTVÍ748804301074185130188236280325378400
/11688043010757
Vnitř12458043010771118137165191
Lék1456804301074083122
2021;1597804301074487129168178
67(e3):1794804301074486106147191212226
e24–e272040804301074487127174220264305
/23658043010757
www.casopisvnitrnilekarstvi.cz442680430107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
finding42548230107244493143163212262
esophageal708482301074984133184234275326371412431
varices1160482301074789116137178221256
and1436482301074796147
due16034823010755103148
to1772482301073481
this,1874482301073483102136153
we20484823010771115
did2184482301075574124
not23294823010754103132
use2481482301075488133
any2635482301074695135
secondary2790482301074085425496301074088137187229256300
prophylaxis.746496301075684132183233272293334375395429446
During12134963010765115142162211261
pregnancy,1495496301075684128179228269318360403415
the1931496301073584129
flow2081496301073053102168
through2270496301073484111159208258307
the2598496301073483128
TIPS2747496301074970116158
was4255103010765107141
free,58751030107255397143158
without766510301076686115164213262291
thrombosis1078510301072978105153228278328363382416
so1514510301073584
we16195103010766110
did1749510301075070120
not1890510301074998126
repeat2037510301072771122167208237
the2294510301072978123
endoscopy.2438510301074493144193227269316367408420
The565524301074292137
patient722524301074890118138182231258
gave1001524301074688128172
birth119452430107476794126175
to1389524301072673
a14825243010739
healthy1541524301074994135155183232272
premature1833524301074775119193234262311338382
baby2235524301074790140180
by2435524301074888
caesarean2543524301073880125160202229273314362
section425538301073479121152172221270
in716538301072372
the809538301073281126
39th956538301074991122171
week11485383010770114160199
of1367538301075378
gestation,1465538301075499133163206234253302352368
with1854538301076990119168
physiological20425383010755104144179198247267316367387428470490
measures25535383010778123164199246274318352
34255523010744
900490552301073682129
g6395523010755
and714552301074796146
51881552301074989
cm.9915523010732107124
She1135552301074897142
came1297552301074688163208
to1526552301073380
the1627552301073383128
clinic177555230107466685134153194
for1990552301072978106
a21165523010747
check-up2183552301074190135177216242292343
425465523010750
months26165523010780129178206255289
after42556630107416598141169
delivery,6145663010755100120139181225253297309
liver94456630107254486130157
cirrhosis112256630107466593121170220254273307
was14495663010771113148
compensated,1617566301074694169219265314348391419462513529
Child-Pugh21675663010757106125145195224271319369418
A,2606566301075877
flows2703566301073053102168203
in425580301071968
TIPS513580301074364110152
free.68658030107255397143158
One5655943010760110155
year741594301074691132159
after920594301074873105148176
birth,1116594301075777104136185202
the1338594301073584129
patient1488594301075699127147191240268
was17775943010771114148
admitted1946594301074798172192221252295346
to2313594301073582
a24165943010747
hospital2484594301074998133183203232274294
for2799594301073078106
acutely425608301074284135165209230273
presented719608301075987133168215265294339391
paresthesia,11326083010758102130175211242293339375395437455
pain16086083010759102123173
and18026083010750100152
mild19766083010783103123175
paresis21726083010759103131176212232267
of2460608301075783
the2564608301073687133
right2719608301073556107157186
lower425622301071968134178206
limb.651622301071938112163179
A8516223010752
magnetic9236223010775117167216261290309350
resonance1294622301072670104154203245294335379
imaging1693622301071893134185204253303
showed2017622301073382131197241292
multiple23306223010773121141170189240260305
lesions265662230107186398117166215249
of425636301074975
vertebrae522636301074995124157202254283327374
spanning918636301074294138189239260310362
from1302636301073262111189
T61512636301075194
to1628636301073685
S21735636301075195
with1852636301077495126177
extraosseal2050636301075395128157201252287323370412433
infiltration2505636301072778103125145175204248278298349400
of425650301074874
intervertebral519650301072776104148176221266294326370421449492512
foramens.1052650301073281109152227273322356374
A14476503010761
staging1529650301073565108159178228278
CT18286503010760106
then1955650301073685131181
discovered2157650301075676110152200242287314359410
multiple25886503010782131151180200251272317
skeletal425664301073473117138183212255275
infiltrates721664301072776101122142171199242270314349
in1091664301072776
vertebrae,1188664301074993121153197248276319365381
ribs,1590664301073454105140157
skull1768664301074281130150170
and1959664301074998149
limb2129664301072747122173
bones23236643010757108158204239
and2583664301074898149
also2753664301074868102152
infiltration42567830107196791112131159187229257276325374
of819678301074570
pancreas909678301074890138179206250291324
and1254678301073887137
breasts.1411678301074775118159193222258275
Based1706678301074385119164215
on1941678301074594
these2056678301072574119153197
findings,227467830107214190140159207257291307
a26026783010738
biopsy2660678301075171119170204245
of425692301074873
the518692301072675120
vertebral659692301073882109141185235263305325
lesion100469230107176297116165214
and1239692301073887137
a13976923010739
trephine1456692301072956100150200219268313
biopsy1789692301074868117168202244
of2053692301074671
an2145692301073887
iliac22536923010716365596138
bone2411692301074898147192
marrow26246923010771113140168216282
were4257063010765109137181
performed.6267063010756102129157205233308353404421
Histology1068706301076382116146193214263314355
results1444706301073276111159178207243
then1708706301073382127176
identified1905706301072575120169197216241262306357
the2283706301073483128
lesions2432706301072469104123172222255
as2708706301074781
an2810706301074695
infiltration42572030107196892113132161189231259279328377
with823720301076686115164
B-lineage100872030107467697116165210251301346
LBL.1375720301074187129147
Our5657343010759107132
patient716734301074586112130172219245
was9807343010760100133
treated113173430107245092131157198247
with1397734301076078105152
several1568734301073073112154180220238
cycles1825734301073677116134176209
of2053734301074366
chemotherapy,2138734301073683126198245271318361386427475513524
however2681734301074491154196425748301074083109
achieved553748301073777125143186226268318
only890748301074492111150
a10597483010738
partial1116748301074990116146164204222
remission1358748301072365138156188221239286334
of1711748301074468
the1798748301072572116
bone1933748301074694142186
and2138748301073785133
organ2291748301074470118158205
lesions251574830107165992110158205238
and2772748301073785133
simultaneously425762301073452125173192220261309353402450483502542
relapsed98776230107256887128177211255305
in1312762301071765
the1397762301072674118
central1535762301073981129156183225244
nervous1798762301074791118162209257290
system.2108762301073273107136179252269
Unfortunately,23967623010755103126174201232280328369396438457497509
the425776301072876120
patient565776301075091118137181229256
died841776301074967111161
210227763010744
years1085776301074083123150184
after128977630107416496138165
the1473776301072876121
oncologic1613776301074897137184204252302321361
diagnosis.1994776301074967108157205253287305338355
Discussion30477174013872105157207271323375408470534
There3187734301074292136162205
are3412734301074774116
no35487343010755103
published36717343010756104154174192225272317367
systematic4057734301074081115144187260301328347387
reviews4464734301073376117136180245279
on47627343010755103
the4885734301073483127
management50317343010781121169210259304377421470496
of3047748301074872
cirrhosis313974830107476693120169218252270303
or3462748301075582
portal35647483010756106133164206225
hypertension3809748301075594145190217248291339373391439488
during43177483010756104130150198248
pregnancy,4585748301075683127177226267315356398410
which50157483010772121140180229
is5264748301072558
likely534274830107264482126145186
because3047762301075095136177225258302
of3369762301074973
the3462762301072977121
low3603762301072068133
prevalence3756762301075178121161203222266314355397
of4173762301074973
cirrhosis426676230107416086113162210244262295
in4580762301072068
women46687623010766114188232280
of4968762301074973
reproductive5061762301072871120147194244292332363382423466
age3047776301074190134
and3201776301073987136
reduced3357776301072467117165205248298
fertility367477630107226592123141160178207249
of3943776301074670
women40327763010763111185229277
with4329776301076382110158
cirrhosis450777630107385683110159207241259291
(10).4818776301072262101124137
Cirrhosis497577630107496894121170218252270303
results5297776301072568101148167195230
Fig.42559501134874126154
2a.606595011359107135
Image76960401071991136182221
of100660401075174
severe109760401073674113150176213
steatohepatitis132760401073763100146172216263301348394420438464482512
in185560401072571
the194260401073279117
cirrhosis20766040107436187113159205235252282
stage237460401073764107153192
(basic258260401073075121152169207
HE2805604010760100
staining,42571401073157101119165183229274290
200×):73171401074686129183207220
predominantly96771401075076113158203275293339384430455474510
macrovesicular1494714010776121158184227265302333350388433451496522
steatosis,20327140107356298143169213243260289306
confluent235471401074285131154174220258304329
ballooning27007140107499511313217742582401074592110156201
degeneration64282401074987133171217256281324350368413460
of111882401074972
hepatocytes120682401075088134180206249288326355391422
with164582401076684110156
Mallory1817824010772117135153198224264
hyaline,209782401075186130149167213251267
focal238082401072771110154172
apoptotic256882401075095141187212256282300337
bodies,42593401074591137156194225241
pronounced68293401075076120166211257304341377423
lobular112193401072368113159178223248
inflammatory13869340107226891111156227299344370413439479
cellularity18819340107427896115160178223249267293332
with223093401076684110156
predominance240293401074975112158203274293339384430467504
of425104401074567
neutrophil508104401074381126151176219264310328345
granulocytes869104401074267109155199217262299337365401431
including131610440107166198115160204222268312
satellitosis,164410440107287297133151169187212255285301330346
extensive2006104401073572100136181210227264301
perisinusoidal2323104401074280105123152168214258287331349393438456
fibrosis27951044010720388242511540107266999116145
and587115401074288133
formation73611540107216591162207232250295342
of1094115401074265
fibrous117511540107203984110154199229
septa.1420115401072866111137180196
Ballooning1632115401074186105123168213260278323368
degeneration2016115401074381126164210248274317342360405451
withMallory2484115401075977103148230275293311356382421
hyaline425126401074682126145163209247
(6881264010726723130604040
–7751264010747
green),838126401074772109147194215228
macrovesicular10821264010773119156181225263300331348386430449494520
steatosis161812640107325995140166210240257286
(192112640107251955130604040
–20061264010747
red),2069126401072764110133146
apoptotic2232126401074692138184209253279297334
body2582126401074793139176
(),27741264010726279512640103802868126401072437
satellitosis425137401073176102138157175193219263293310339
(7801374010724
),834137401072437
perisinusoidal887137401074684110128158175221266296340359404449468
fibrosis137113740107234287113157187204233
(#)162013740107246283
Fig.304759501134874126155
2b.3230595011356107134
Image339360401071991137183222
of363360401074670
severe372160401073371110148175213
steatohepatitis39516040107336097143170215262301348395421440467486516
in448460401072168
the456960401072875114
cirrhosis47006040107405885111158204235253284
stage500160401073360104150189
(basic520860401072572118149167205
HE543060401075797
staining,304771401073157100118164182228273289
400×):335271401073981124177201215
predominantly358371401074369105151195266285330375421446464501
macrovesicular4101714010768113150176219257294325342379424442487513
steatosis,46307140107295592137163206236253283299
confluent494571401073578125147168213251297322
ballooning528371401074388107125170216304782401074665112158
degeneration322282401074887134173220259286329356375421469
of370882401074771
hepatocytes379782401074988134181208252292331360398430
with424482401076584111157
Mallory4419824010770116136155201227268
hyaline,470482401074985131150169216255272
focal499382401072671110155174
apoptotic518482401074895142188215259286305343
bodies,304793401074591138157196227244
pronounced330893401074470115162207254301339376422
lobular374693401071763109155174220246
inflammatory40099340107176386108153225296342369413439480
cellularity45059340107367392111157176221248267293333
with485593401076079105152
predominance502493401074370107153199271289336381428466503
of3047104401074569
neutrophil3133104401074887133160186231278325345364
granulocytes3514104401074673116163209229275314353382420452
including3983104401072067105124170216235282328
satellitosis,4328104401073378105143162181200227271302320351368
extensive4713104401073978108145192223241280317
perisinusoidal5048104401074686112131162180227273303348368414460480
fibrosis.304711540107234389116161192210240258
Ballooning3322115401075096116135181228275294341387
degeneration3726115401075291138177224263290334361380426473
with4216115401076988115162
Mallory43951154010774120140159205232272
hyaline4684115401075390135154174221260
(496111540107305000119604040
–50521154010752
green),5120115401075178116155202224239
macrovesicular537611540107781243047126401073764108147185217235273319338384411
steatosis3475126401073663100146173218249267297
(378912640107293827130604040
–38791264010750
red),3945126401073168115139153
apoptotic4116126401075096143189216261287306344
body4478126401075096143181
(),46761264010729470112640103804775126401072438
satellitosis4830126401073682109146165185204230275306324354
(52011264010729
),5261126401072439
perisinusoidal53171264010750891161351651833047137401074693123168188234280299
fibrosis336313740107244490117162193211241
(#)362113740107256485
Fig.425293601134873125152
2c.604293601135492121
Image752294401071990135180219
of987294401074568
severe1071294401073168107144169206
steatohepatitis129329440107315794139165209255293339385411429454473502
in1811294401071864
the1891294401072672110
cirrhosis201829440107375580106152197227244274
stage2308294401073157100145184
(van2508294401072359103150
Gieson2674294401075371109140185231
stain,425305401073157101119165181
200×):622305401074080123177200214
porto852305401074490116144188
central1056305401073672118144169212230
and1302305401074490136
porto1454305401074489115144187
portal1658305401074389115144187205
fibrous187930540107224186112156202231
septa2126305401073068113139182
and2324305401074490136
marked24763054010770115141177215260
perisinusoidal275230540107448310912742531640107314894139169213232277322341
fibrosis78231640107234287113157187204233
(reddish103231640107234783129174192222267
staining)1315316401073157100119165183229274297
Fig.3047302701134873125152
2d.32263027011353103131
Image3384303501071990135180219
of3619303501074467
severe3702303501072967105142168205
steatohepatitis392330350107305692138164207254292338384409427453471501
in4440303501071763
the4519303501072571109
cirrhosis464430350107365480105152197227244273
stage493330350107305699145183
(van5132303501072359103149
Gieson5297303501075270108140184231
stain,3047314501073157101119165181
400×):3244314501074183126180204217
marked34773145010772117143179217262
perisinusoidal3755314501074684110128158175221266296340359404449467
fibrosis423931450107234187113156186204233
(reddish448831450107244784129175193222267
staining)4771314501073258101119165183229274297
Fig.3047482201134873124151
3.3225482201135177
Ultrasound332948300107547197122164194238284330374
and3720483001074288133
Doppler3869483001075399144190208246271
of4156483001074365
the4237483001072469107
liver.436048300107163472108134147
After452248300107466897133159
TIPS469748300107365598136
procedure4849483001074268112150186231276301338
–52034830010742
implanted52614830010715861311491942403047494001072663108
stent317249400107315793140165
graft3353494001074571114136165
with3534494001076381107153
normal3703494001074691117189234252
flow397149400107234489151
velocities413849400107387594139177195221239277308
around4462494001074571115161207252
904731494001074184
cm/s48314940010732103133161