Blood, 1958, Vol. 13, No. 5, pp. 427-435.
© 1958 American Society of Hematology, Inc.
Polycythemia in Primary Carcinoma of the Liver
A. J. S. MCFADZEAN 1,
DAVID TODD 1, and
K. C. TSANG 1
1 University Department of Medicine and Queen Mary Hospital, Hong Kong.
In a series of 176 consecutive patients with hepatocarcinoma an increase
in red cell count and in hemoglobin significantly above normal levels were
encountered in 17 (10 per cent).
An investigation of 28 patients with hepatocarcinoma developing in a
cirrhotic liver is reported. In three of the patients (10 per cent), the red
cell counts and hemoglobin levels were significantly above those encountered
in healthy Chinese.
In these 28 patients it has been shown that the plasma volume is increased,
and this increase does not differ significantly from that encountered in uncomplicated cirrhosis of the liver. The total red cell volume, on the other
hand, is significantly greater than in uncomplicated cirrhosis of the liver. While
the mean total red cell volume in hepatocarcinoma is not significantly different from that in healthy controls, consideration of this finding in individual
patients shows that it was above normal in 17, normal in six, and in the remaining five it was below normal.
It is concluded that the polycythemia encountered is a true polycythemia
secondary to the development of the hepatocarcinoma. The expanded plasma
volume is considered probably attributable to the pre-existing cirrhosis of
the liver. Unfortunately, in the course of this investigation we did not encounter a patient in whom the carcinoma had developed in a liver which
was not cirrhotic.
Submitted on April 8, 1957
Accepted on November 18, 1957
