Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 55, Issue 7
Displaying 1-6 of 6 articles from this issue
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Case Reports
  • Virological analysis of hepatitis B virus derived from patients who developed acute liver failure during HBs antigen negative phase
    Riki Kondo, Kiyoaki Ito, Yukiomi Nakade, Takaya Yamamoto, Yuji Kobayas ...
    2014 Volume 55 Issue 7 Pages 378-383
    Published: July 20, 2014
    Released on J-STAGE: July 31, 2014
    DOIhttps://doi.org/10.2957/kanzo.55.378
    JOURNAL FREE ACCESS
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    A 41-year-old man was seen in our hospital because of fever elevation (40°C) and icterus. The patient was diagnosed as an acute liver failure, since blood test showed an elevation of transaminase and a low percentage of prothrombin time. Although HBsAg was negative when the patient was admitted, the cause of acute liver failure was diagnosed as infection of hepatitis B virus (HBV) because of high titer of anti-HBc of the IgM class and the positive of HBV-DNA. In this patient, we tried to determine the sequence of HBV to analyze the cause of HBsAg negativity when the patient was admitted. Whole DNA sequence of HBV was not successfully determined because of low titer of HBV DNA, whereas only the sequence of S gene could be determined. The result of amino acid sequence of envelope protein did not show mutations which influence the recognition by the measurement system in the " a" determinant. Therefore, negativity of HBsAg in the patient may be attributed to the condition that HBsAg was less than measurement seisitivity in the sera by a potent immune response rather than the influence of amino acid mutations. It was very rare case to be determined the sequence of HBV successfully in the acute hepatitis B during the HBsAg negative state. Anti-HBc of the IgM class and HBV-DNA should be checked when patient was suspected to be acute hepatitis B even though HBsAg was negative.
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  • A case of laparoscopic partial resection of large regenerative nodule difficultly distinguished from hepatocellular carcinoma
    Takayoshi Nakajima, Tadashi Tsukamoto, Akishige Kanazawa, Sadatoshi Sh ...
    2014 Volume 55 Issue 7 Pages 384-391
    Published: July 20, 2014
    Released on J-STAGE: July 31, 2014
    DOIhttps://doi.org/10.2957/kanzo.55.384
    JOURNAL FREE ACCESS
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    A 40-year-old woman received combination therapy of pegylated interferon alpha-2b and ribavirin for chronic hepatitis C in 2005 and achieved sustained virological response. But since relapse in 2006, she had received only liver supporting therapy. In 2010, abdominal dynamic computed tomography (CT) showed a low attenuation lesion, 2 cm in diameter, in segment 3 of the liver on the arterial to the equilibrium phase. Based on imaging findings, we suspected hypovascular well-differentiated hepatocellular carcinoma (HCC) concomitant with lipid, and performed laparoscopic partial resection of segment 3 of the liver. The resected specimen showed histopathologically cirrhotic liver in which a nodule, 21 mm in diameter, had same structure as the surrounded regenerative nodules. Therefore the nodule was diagnosed large regenerative nodule (LRN). It may be difficult to distinguish LRN from HCC clinically and with imaging modalities. We diagnosed this case as having LRN by laparoscopic resection of the liver.
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  • A case of resected huge hepatic angiomyolipoma showing FDG uptake in PET/CT
    Tomoe Kawamura, Atsushi Hiraoka, Toshihiko Aibiki, Tomonari Okudaira, ...
    2014 Volume 55 Issue 7 Pages 392-398
    Published: July 20, 2014
    Released on J-STAGE: July 31, 2014
    DOIhttps://doi.org/10.2957/kanzo.55.392
    JOURNAL FREE ACCESS
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    A 33-year-old Chinese woman was admitted to our hospital due to recent body weight loss (15 kg/year). Contrast enhanced computed tomography (CT) and ultrasonography (US) examinations revealed a huge hepatic tumor (17 cm in diameter) in the left hepatic lobe. There were no viral hepatic diseases or alcohol abuse, and no elevation of tumor markers (AFP, PIVKA-II, CEA, CA19-9). Contrast enhanced US with Sonazoid® showed the feeding artery, as well as heterogeneous enhancement from the periphery in the early vascular phase and a perfusion defect in the post-vascular phase. FDG uptake in the tumor (SUV max 6.1) was shown by FDG PET/CT. Following resection, the tumor was diagnosed histologically as a hepatic angiomyolipoma. In spite of recent advancements, it remains difficult to diagnosis a hepatic angiomyolipoma based on imaging findings.
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  • Long-term interferon therapies improved hepatic fibrosis and prevented the recurrence of hepatocellular carcinoma in a patient with hepatitis C virus infection
    Masashi Kusanaga, Masaaki Hiura, Sota Minami, Koichiro Miyagawa, Shinj ...
    2014 Volume 55 Issue 7 Pages 399-404
    Published: July 20, 2014
    Released on J-STAGE: July 31, 2014
    DOIhttps://doi.org/10.2957/kanzo.55.399
    JOURNAL FREE ACCESS
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    We report a 27-year-old male patient received long-term interferon (IFN) therapies for hepatitis C virus (HCV) infection. He had suffered from infantile fulminant hepatitis due to hepatitis B virus. He was infected with HCV by the treatment for the hepatitis. He was histologically diagnosed as having liver cirrhosis and received interferon therapy at the age of 2. He was diagnosed as hepatocellular carcinoma (HCC) at the age of 8, received surgical treatment and continued IFN therapy at the age of 23. He received liver biopsy at the age of 25; the fibrosis had improved even though the HCV had not been cleared. There is no recurrence of HCC during this period. Chronic inflammation plays an important role in liver fibrosis in patients with HCV infection. If liver fibrosis progresses, the incidence of HCC increases. Long-term interferon treatment is useful to improve the fibrosis and reduce the incidence of HCC.
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