Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 54, Issue 12
Displaying 1-6 of 6 articles from this issue
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Review Article
  • Pathological diagnosis of benign hepatocellular nodular lesions based on the new World Health Organization Classification
    Fukuo Kondo, Yurie Soejima, Toshio Fukusato
    2013 Volume 54 Issue 12 Pages 807-818
    Published: December 11, 2013
    Released on J-STAGE: January 08, 2014
    DOIhttps://doi.org/10.2957/kanzo.54.807
    JOURNAL FREE ACCESS
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    Benign hepatocellular nodular lesions have been classified into various categories according to the traditional detailed criteria until recently. In 2010, a new classification and diagnostic methods for hepatocellular adenoma (HCA) were described in the World Health Organization Classification. HCAs were classified into the four subtypes based on the advanced molecular and immunohistochemical studies. These molecular and immunohistochemical methods were also applied to the differential diagnosis of focal nodular hyperplasia (FNH). However, the new criteria sometimes conflict with the traditional one because of the difference of diagnostic basis. Histological diagnoses are different in some cases. In this article, a new concept of benign hepatocellular nodular lesions was described to solve this problem.
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Case Reports
  • A case of laparoscopic radiofrequency ablation therapy using bipolar RFA system for hepatocellular carcinoma
    Kunihiko Tsuji, Hajime Yamazaki, Kazumasa Nagai, Takeshi Matsui, Akiko ...
    2013 Volume 54 Issue 12 Pages 819-825
    Published: December 11, 2013
    Released on J-STAGE: January 08, 2014
    DOIhttps://doi.org/10.2957/kanzo.54.819
    JOURNAL FREE ACCESS
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    We report a case of laparoscopic radiofrequency abltion therapy (RFA) for hepatocellular carcinoma (HCC) using bipolar RFA system. A 74-year-old man was admitted to our center for HCC at segment 4 in the liver. Ultrasonography could not detect the HCC. Liver function was Child-Pugh class B. We performed laparoscopic RFA under general anesthesia using bipolar RFA system and obtained a sufficient ablative margin. No complication was observed during and post-RFA. Laparoscopic RFA for the surface-type HCC using bipolar RFA system was a safe and highly effective procedure.
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  • A case of chronic hepatitis C complicated with fibromyalgia treated with human interferon beta and ribavirin
    Takuji Akamatsu, Yukitaka Yamashita, Miyu Nobuoka, Shunjirou Azuma, Mi ...
    2013 Volume 54 Issue 12 Pages 826-833
    Published: December 11, 2013
    Released on J-STAGE: January 08, 2014
    DOIhttps://doi.org/10.2957/kanzo.54.826
    JOURNAL FREE ACCESS
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    The patient was a 35-year-old woman. She had been diagnosed as having fibromyalgia when she was 31 years old and was under going to our hospital regularly to department of Rheumatology and psychosomatic medicine. She had been diagnosed as chronic hepatitis C (genotype 2a, high viral load) also when she was 20 years old, and she visited to department of Gastroenterology and Hepatology in March 2012 with a strong wish for the interferon (IFN) therapy. She was treated with the combination therapy of natural human IFN beta and Ribavirin. Fortunately, the therapy was completed with neither major side effects nor exacerbation of fibromyalgia, and sustained virological response was acquired. However, since the etiology of fibromyalgia is unclear and the effect of IFN for fibromyalgia is not known sufficiently, IFN therapy for fibromyalgia patient is needed to be considered carefully with sufficient explanation for the patient.
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  • Hepatocellular carcinoma close to major vascular involvement was successfully treated with stereotactic body radiotherapy
    Kana Tojo, Ichiro Otani, Mikiya Kitamoto, Yuno Omura, Ayami Hukiage, S ...
    2013 Volume 54 Issue 12 Pages 834-840
    Published: December 11, 2013
    Released on J-STAGE: January 08, 2014
    DOIhttps://doi.org/10.2957/kanzo.54.834
    JOURNAL FREE ACCESS
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    A 75-year-old woman was admitted to our hospital with a large hepatic tumor in hepatic portal region. Her hepatic reserve was classified into Child class A. alpha-fetoprotein was 276 ng/ml, and protein induced by vitamin K deficiency and antagonist-II (PIVKA-II) was 74 mAU/ml. The tumor was diagnosed with hepatocellular carcinoma (HCC) close to large vessels such as right branch of the portal vein, right hepatic vein, middle hepatic vein, and inferior vena. Therefore, RFA and surgery was not candidate due to the location of the tumor, and she had been treated transcatheter arterial chemoembolization (TACE) using doxorubicin followed by stereotactic body radiotherapy (SBRT) one month after TACE. The dose was 45 Gy in 5 fractions. She has been well, and the levels of both markers became negative and continued within normal range for 4 years.
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  • A case of hepatitis B virus-related liver cirrhosis with large portal vein aneurysm and rectal varices due to liver biopsy
    Yuka Endo, Yuka Kowazaki, Jun Imamura, Kiminori Kimura, Syunichi Saeki ...
    2013 Volume 54 Issue 12 Pages 841-849
    Published: December 11, 2013
    Released on J-STAGE: January 08, 2014
    DOIhttps://doi.org/10.2957/kanzo.54.841
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    A 56-year-old man with hepatitis B virus (HBV)-related liver cirrhosis with large portal vein aneurysm and rectal varices due to laparoscopic liver biopsy more than 14 years previously was admitted to our hospital in April 2004. Computed tomography (CT) and abdominal angiography revealed a dilated right hepatic artery (RHA), large portal vein aneurysm, and several hepatofugal collaterals such as a dilated inferior mesenteric vein (IMV), spleno-renal (S-R) shunt, and markedly dilated rectal venous plexus occupying the pelvic cavity. Coiling of the dilated RHA, closure of the IMV, Balloon-occuluded retrograde transvenous obliteration for S-R shunt, and endoscopic variceal ligation for ruptured rectal varices were then performed from July 2004 to January 2009. As a result, hepatopetal blood flow appeared increased on superior mesenteric arteriography, and liver function improved with every treatment.
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Short Communication
  • Clinical trial of percutaneous radio frequency ablation therapy by two-step insertion method using VirtuTRAXTM instrument navigator
    Teiji Kuzuya, Yoji Ishizu, Takurou Niinomi, Norihiro Imai, Kouichi Ach ...
    2013 Volume 54 Issue 12 Pages 850-853
    Published: December 11, 2013
    Released on J-STAGE: January 08, 2014
    DOIhttps://doi.org/10.2957/kanzo.54.850
    JOURNAL FREE ACCESS
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    We performed percutaneous radio frequency ablation (RFA) therapy by two-step insertion method using VirtuTRAXTM (GE Healthcare, USA) instrument navigator. Subjects were 16 patients (23 nodules) with hepatocellular carcinoma. VirtuTRAXTM position sensor was attached to the hilt of 14-gauge outer needle. In all cases, we could perform 17- gauge Cool-tip RFA without the positional gap between the virtual tract and the actual needle which was caused by the deflection of the needle. The reasons without causing the positional gap were that the outer needle was more rigid than Cool-tip needle, and that it was inserted using initial insertion of a 21-gauge guided needle. RFA by two-step insertion method using VirtuTRAXTM is suggested to be more safe and effective than conventional RFA.
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