Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
Search
Advanced search
OR
Browse
Search
Volume 50, Issue 5
Displaying 1-7 of 7 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Editorial
Case Reports
  • A case of autoimmune hepatitis showing resistance to a steroid and immunosuppressants
    Ritsuzo Kozuka, Shuji Iwai, Madoka Toyama, Hideki Fujii, Takahiro Yasu ...
    Article type: Case Report
    2009 Volume 50 Issue 5 Pages 223-228
    Published: 2009
    Released on J-STAGE: June 03, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.223
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 27-year-old woman consulted a doctor with nasal congestion. At that time, a high level of γ-globulin and IgG was observed in her blood test. Afterwards, she was admitted to our hospital because of a high level of serum transaminases. We diagnosed her disease as autoimmune hepatitis following the results of several serum tests and the liver histopathology obtained by liver biopsy. She was initially treated with prednisolone (PSL) 30 mg/day. Because we found that the steroid treatment was insufficient, we further added azathioprine (AZA) 50 mg/day to the steroid. Use of AZA showed some effect. However, the hepatopathy did not improve and the medication was changed to cyclosporine (CYA) because agranulocytosis was observed as a side effect. The patient died following a sudden decline of consciousness and acute respiratory failure due to a pneumocystis carinii infection. We here report a case that showed resistance to treatment using a steroid, AZA, and CYA.
    View full abstract
    Download PDF (600K)
  • A case of biopsy-proven idiopathic peliosis hepatis disseminated to whole liver with rapidly worsening course
    Takuya Kitahara, Yasuhito Kubo, Kai Yoshizawa, Hiroshi Abe, Ryouichi A ...
    Article type: Case Report
    2009 Volume 50 Issue 5 Pages 229-237
    Published: 2009
    Released on J-STAGE: June 03, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.229
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Here we report a 62 y/o male who was diagnosed as idiopathic peliosis hepatis by liver biopsy and had a rapidly worsening course complicated with disseminated intravascular coagulation (DIC). He was pointed out liver dysfunction by routine check-up, and diagnosed as having peliosis hepatis that was distributed to whole liver by liver biopsy and abdominal CT at the beginning of September 2006. He was followed-up regularly afterward. He has been symptom-free with mild unchanged liver dysfunction until the middle of August 2007, when he suddenly complained back pain and right hypochondralgia with remarkable hepatomegaly. The blood tests showed that he had DIC with remarkable worsening of liver function. Living donor liver transplantation was planned. However, he developed hepatic failure complicated with pneumonia to die 2 months later with no chance for the liver transplantation. The present case suggests that peliosis hepatis disseminated to whole liver might cause DIC thus needs careful follow up.
    View full abstract
    Download PDF (1873K)
  • A case of hepatocellular carcinoma who cleared hepatitis C virus with interferon therapy 13 years ago
    Michiyasu Yagura, Akihisa Tanaka, Hiroshi Kamitsukasa
    Article type: Case Report
    2009 Volume 50 Issue 5 Pages 238-243
    Published: 2009
    Released on J-STAGE: June 03, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.238
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Here we report a 75 y-o male with chronic hepatitis C who developed hepatocellular carcinoma (HCC) in spite of the clearance of HCV with standard interferon (IFN) therapy 13 years ago. To see if the development of HCC was related to HCV replication, we examined both positive and negative strands of HCV RNA in the liver tissue by using digoxigenin-labeled cRNA probes. The results showed negative for both strands. In 1994, he was diagnosed as chronic hepatitis C and his liver histology showed F1A1. He received standard IFN therapy for 24 weeks and became a sustained virological responder (SVR). After that, he was followed up by blood test and ultrasound (US) examination every 6 months. In Aug, 2007, he was found to have a hypoechoic tumor (1.5 cm in diameter) in segment 8 of the liver, which was compatible with HCC. Radiofrequency ablation was successfully done two months later. In Feb, 2008, liver biopsy was done again to examine progression of liver histology and the presence of positive/negative strands of HCV RNA in the liver, but the results showed F1A0, and both strands were negative. To deny the possibility of involvement of occult hepatitis B virus (HBV) in this case, we examined for HBsAg/HBV DNA in serum and liver as well as for immunostaining of HBsAg/HBcAg in the liver (regrettably not for integration of HBV DNA in HCC tissue). The results revealed all were negative, therefore we concluded this possibility was very low. The current case suggests that the aged, male patients may have a certain risk to develop HCC in spite of the clearance of HCV with therapy, even in the absence of advanced liver fibrosis or alcohol abuse, thus should be carefully followed up long after the clearance of the virus.
    View full abstract
    Download PDF (625K)
  • A case of spontaneous complete necrosis of hepatocellular carcinoma
    Akiyuki Kanzaki, Soki Hibino, Tetsuo Nishi, Takatsugu Kawagoe, Akihiro ...
    Article type: Case Report
    2009 Volume 50 Issue 5 Pages 244-249
    Published: 2009
    Released on J-STAGE: June 03, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.244
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    We report a rare case of spontaneous complete necrosis of hepatocellular carcinoma. A 72-year-old man underwent distal gastrectomy due to perforation of gastric ulcer 50 years ago, and then was transfused. He had visited a hospital near his home to be treated for chronic hepatitis C and diabetes. Because we suspected him to be in the recovery stage of acute renal failure of unknown cause, he was admitted to our hospital. CT showed a mass of 2.5 cm in segment 8 of the liver. After that, we observed him for 8 months. The liver mass evidenced no remarkable change in size. Liver angiography showed ring enhancement consistent with the mass. AFP level was high at 972 ng/ml and PIVKA II level was also high at 1880 mAU/ml. We considered him to have hepatocellular carcinoma, and performed a partial resection of the liver. The resected specimen showed a tan necrotic mass with capsular formation. Histological findings showed complete necrosis of the cells in the mass, and no viable tumor cells were found. Postoperative tumor markers, AFP and PIVKA II, decreased to the normal range, so we considered it to be a case of spontaneous complete necrosis of hepatocellular carcinoma.
    View full abstract
    Download PDF (785K)
  • A case of relapsed hepatocellular carcinoma successfully evaluated by contrast-enhanced ultrasonography using SonazoidTM
    Suguru Yoneda, Satoru Joshita, Tetsuya Ichijo, Atsushi Kamijo, Michiha ...
    Article type: Case Report
    2009 Volume 50 Issue 5 Pages 250-256
    Published: 2009
    Released on J-STAGE: June 03, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.250
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 68 year-old woman was admitted to our hospital for treatment of relapsed hepatocellular carcinoma (HCC) in 2008. She was being medicated for chronic hepatitis B infection and had undergone hepatic partial lobectomy and transcatheter arterial embolization (TAE) three times over a span of 4 years. The hepatic tumor measuring 20 mm in diameter was depicted after several treatments on hepatic segment 4 by computed tomography. Although she was scheduled to receive TAE again, the therapy was cancelled due to discovery of an arterio-portal shunt. Conventional ultrasonography (US) showed multiple hypoechoic lesions with capsules that were clearly depicted as homogeneous hyper-echoic lesions in arterial phase and then as contrast defects in Kupffer phase using contrast-enhanced US with SonazoidTM. She was successfully treated with percutaneous ethanol injection therapy (PEIT). The same imaging technique revealed a new HCC lesion in the same area 3 months afterwards, which was again treated with PEIT. In light of the above, it can be said that contrast-enhanced US using SonazoidTM is an effective method for detection of hepatic tumors, which clinicians normally have difficulty diagnosing as relapsed HCC following several prior treatments.
    View full abstract
    Download PDF (733K)
Rapid Communication
  • Usefulness of Gd-EOB MRI in evaluation of portal vein embolization
    Masami Asakawa, Masanori Matsuda, Katsuhiro Sano, Takuji Araki, Hideki ...
    Article type: Rapid Communication
    2009 Volume 50 Issue 5 Pages 257-259
    Published: 2009
    Released on J-STAGE: June 03, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.257
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Portal vein embolization (PVE) has been used in the preoperative treatment for major hepatectomy, and CT scan used as a useful tool for the evaluation of the hepatic volume change. In this report, we evaluated the efficacy of the Gd-EOB-DTPA MRI in 4 cases, by comparing with the results of conventional CT scan. All 4 cases underwent trans-ileocecal portal vein embolization (TIPE), and both Gd-EOB MRI and CT scan were performed after 2-4 weeks after PVE. In the hepatobiliary phase, the embolized lobe was shown as a low intensity area by CT scan; however, the Gd-EOB MRI demarcated the line between the embolized and non-embolized lobe more clearly. In addition, reduction of the excretion of contrast medium into the bile duct in the embolized lobe was remarkable, indicating that Gd-EOB-DTPA MRI could reflect no function of the embolized lobe. The present findings suggest that the Gd-EOB-DTPA MRI appears to be more useful in the evaluation of PVE than the conventional CT scan.
    View full abstract
    Download PDF (336K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top