Abstract
The patient was a 50-year-old male with a long history of chronic alcoholism and a blood transfusion at the age of 30 years. He received a daily oral dose of 70mg of cyanamide for about 3 years until 5 months before admission. He was admitted to the hospital because of persistent fatigability. There were no signs of neurological disease. Biochemical liver function tests showed moderate liver injuly. Serum HBs antigen, HBs antibody and HBc antibody were negative by radioimmunoassay. Laparoscopy performed on the 5th day of the admission revealed a mottled liver. A needle liver biopsy specimen had numerous ground-glass inclusions in hepatocytes predominantly of periportal areas. The inclusions were negative by orcein and immunoperoxidase stainning for HBs antigen and HBc antigen. Ultrastructurally, the inclusions mainly consisted of hyperplastic smooth endoplasmic reticulum with irregular figures and cisterna dilation, glycogen, and lysosomes.
