Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 51, Issue 3
Displaying 1-6 of 6 articles from this issue
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Original Article
  • Diagnosis of hepatocellular carcinoma by contrast-enhanced ultrasound with Perfluorobutane and enhanced magnetic resonance imaging with Gd-EOB-DTPA
    Toshifumi Tada, Takashi Kumada, Hidenori Toyoda, Seiki Kiriyama, Kenji ...
    Article type: Original Article
    2010 Volume 51 Issue 3 Pages 99-106
    Published: 2010
    Released on J-STAGE: April 06, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.99
    JOURNAL FREE ACCESS
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    Aim: We evaluated the usefulness for the diagnosis of hepatocellular carcinoma (HCC) of a contrast-enhanced ultrasound (CEUS) method using a Kupffer cell-specific contrast agent, perfluorobutane, as well as enhanced magnetic resonance imaging (MRI) using a hepatocyte-specific contrast agent, gadolinium-ethoxybenzyl-diethlenetriamine pentaacetic acid (Gd-EOB-DTPA).
    Materials and methods: We analyzed the results of enhanced MRI with Gd-EOB-DTPA and/or CEUS with perfluorobutane in the examination of 338 HCC nodules in 217 patients that were also studied by computed tomography (CT) during arterial portography (CTAP) and during hepatic arteriography (CTHA). A diagnosis of HCC was confirmed for 313 nodules in 199 patients by the presence of typical findings for HCC on CTAP and CTHA. For eight additional nodules in eight patients without the typical imaging findings on CTAP/CTHA, HCC was confirmed by the pathologic findings of the biopsied specimen.
    Result: Three hundred fourteen patients underwent enhanced MRI with Gd-EOB-DTPA, while 206 patients underwent CEUS with perfluorobutane. For liver nodules possessing the typical imaging findings of HCC, 284 of 289 nodules (98.3%) were detected as hypo- or hyperintense nodule on the hepatobiliary phase of enhanced MRI with Gd-EOB-DTPA, and 154 of 181 nodules (85.1%) were detected as a defect or low-echogenic nodule on the post-vascular phase of CEUS with perfluorobutane. For HCC nodules lacking the typical imaging findings, all eight nodules were detected on the hepatobiliary phase of enhanced MRI with Gd-EOB-DTPA as hypointense nodules. In contrast, only one of the eight nodules (12.5%) could be detected on the post-vascular phase of CEUS with perfluorobutane. All eight nodules were confirmed to be well-differentiated HCC by histopathological examination.
    Conclusions: Enhanced MRI with Gd-EOB-DTPA is an excellent imaging modality to detect HCC and is superior to CEUS with perfluorobutane. This imaging modality can detect well-differentiated HCC, even those lesions lacking the typical imaging findings. This method may not detect a subset of HCC with typical imaging findings, however, making the combination of different imaging modalities is important in diagnosis.
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Case Reports
  • A case of acute hepatitis B by HBV genotype E
    Naoki Harada, Akira Takeda, Takamichi Haruna, Yoshinobu Saitou, Tetsuj ...
    Article type: Case Report
    2010 Volume 51 Issue 3 Pages 107-111
    Published: 2010
    Released on J-STAGE: April 06, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.107
    JOURNAL FREE ACCESS
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    A 35-year-old Japanese female was admitted for remarkable hepatic dysfunction. She had traveled abroad frequently and had a history of sexual partnership with multiple foreigners. Examinations revealed that she was infected with hepatitis B virus (HBV) of genotype E, a very rare genotype in Japan. Since her hepatitis was deteriorating after admission, we started administration of entecavir on 18th hospital day. It took about 6 months until HBsAg was replaced by anti-HBs, and HBV DNA decreased to undetectable level. Here we report this case in detail because HBV genotype E infection is rarely experienced in Japan.
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  • The utility of natural human interferonβ in a case of chronic hepatitis C with a history of peg-interferonα2a related erythema multiforme
    Hirokazu Takahashi, Yuichirou Eguchi, Haruko Uemura, Takuya Inoue, Nor ...
    Article type: Case Report
    2010 Volume 51 Issue 3 Pages 112-118
    Published: 2010
    Released on J-STAGE: April 06, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.112
    JOURNAL FREE ACCESS
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    A sixty-four-year-old woman received anti-viral therapy with peg-interferon alpha 2a. Erythema was detected in her upper arm after the fourth administration; then the erythema spread widely over the body in a few weeks. Peg-interferon therapy was promptly discontinued. After being admitted to our hospital she was diagnosed with erythema multiforme induced by peg-interferon alpha 2a. After her erythema multiforme had been resolved by administering internal prednisolone and topical corticosteroid, an antiviral therapy of intravenous natural human interferon beta was initiated without any major side effect or cutaneous symptoms. The patient was eventually able to achieve a sustained viral response. Natural human intravenous interferon beta is considered to be an antiviral therapy for the treatment of chronic hepatitis C patients with severe cutaneous symptoms because of the administration of peg-interferon.
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  • A case of multiple hepatocellular carcinoma successfully treated by transcatheter arterial infusion chemotherapy and transcatheter arterial chemoembolization using IA-call®
    Kazuhiro Takahashi, Kiyoshi Fukunaga, Akihiko Kobayashi, Soichiro Mura ...
    Article type: Case Report
    2010 Volume 51 Issue 3 Pages 119-126
    Published: 2010
    Released on J-STAGE: April 06, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.119
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    We experienced a case of multiple hepatocellular carcinoma successfully treated by transcatheter arterial infusion chemotherapy (TAI) and transcatheter arterial chemoembolization (TACE) using IA-call®. The patient was 65 year-old female with bilateral multiple hepatocellular carcinoma resistant to TACE using mitomycin C. TAI using IA-call® was performed, and after the 10th TAI, all the tumors became undetectable. AFP and PIVKA-II decreased to the normal value. The side effects were mild nausea, appetite loss, hepatic impairment and fever, which disappeared within a week. Although a single recurrent nodule was detected 6 months after the 10th TAI, the tumor was successfully controlled with complete response by TACE using IA-call®. Some clinicians have reported a case with drastic sensitivity to IA-call®. Further research is needed to elucidate biological trait of IA-call® sensitivity.
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  • A case of biliary cystadenocarcinoma exhibiting gastric foveolar-type mucin
    Manabu Nagayama, Norio Isoda, Mitsuaki Sato, Yuji Ino, Ryou Toyoda, Na ...
    Article type: Case Report
    2010 Volume 51 Issue 3 Pages 127-134
    Published: 2010
    Released on J-STAGE: April 06, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.127
    JOURNAL FREE ACCESS
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    The patient was a 53-year-old woman referred to our department for evaluation of a giant intraabdominal cystic lesion in May 2008. Imaging studies revealed a unilocular cystic lesion with multiple mural nodules that was considered to originate from the left lobe of liver. She underwent resection of the left lobe of liver. The cystic tumor, 28×24 cm in size, weighed 5.5 kg was removed en block and no lymph node metastasis was observed. Within the cystic wall, multiple papillary nodules composed of mucinous columnar epithelium exhibiting mitosis and nuclear atypism were scattered leading to the diagnosis of biliary cystadenocarcinoma. Neither ovarian-like stroma nor communication between the bile duct and the tumor was evident. Immunohistochemical staining showed that the epithelial cells were diffusely positive for MUC5AC, partially positive for MUC1, and negative for MUC2 and MUC6, indicating gastric foveolar-type mucin was the major mucin phenotype in both cancerous and non-cancerous epithelium of the tumor.
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Special Article
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