Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 56, Issue 9
Displaying 1-5 of 5 articles from this issue
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Review Article
Case Reports
  • Focal nodular hyperplasia-like lesion of progressive type in a patient with congenital hepatic fibrosis: a case report
    Mie Arakawa, Koichi Honda, Masataka Seike, Tomoko Tokumaru, Kosiro Tsu ...
    2015 Volume 56 Issue 9 Pages 461-468
    Published: September 20, 2015
    Released on J-STAGE: October 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.461
    JOURNAL FREE ACCESS
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    A 46-year-old woman was diagnosed with congenital hepatic fibrosis by histological examination of a liver biopsy specimen in 2001. She was routinely followed up with computed tomography (CT) examinations. She had some liver nodules,but these nodules did not enlarge. In August 2013, dynamic CT revealed a lesion with early arterial uptake in the right hepatic lobe. The nodule enlarged progressively. Histopathological examination of a tumor biopsy specimen revealed a well-differentiated hepatocellular carcinoma. The tumor was treated by chemolipoidolization and radiofrequency ablation therapy. The patient developed acute cholangitis 1 year later, and her liver function deteriorated rapidly. She died of hepatic failure at 47 years of age. After careful re-evaluation of histological findings and additional immunohistochemical study, the diagnosis was revised to be a FNH-like lesion of the progressive type.
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  • A case of hepatocellular carcinoma with disappearance of lymph node metastasis after sorafenib administration
    Masahiro Hayashi, Tetsuhiro Chiba, Sadahisa Ogasawara, Yoshihiko Ooka, ...
    2015 Volume 56 Issue 9 Pages 469-476
    Published: September 20, 2015
    Released on J-STAGE: October 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.469
    JOURNAL FREE ACCESS
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    We describe a patient with recurrent hepatocellular carcinoma (HCC) in the remnant liver and lymph node metastasis after hepatectomy. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) showed an increase in FDG accumulation in a lymph node around the head of the pancreas but not in liver tumors. One year after sorafenib administration, neither the lymph node nor the intrahepatic tumors exhibited FDG accumulation. Although two known intrahepatic tumors became enlarged, no new intra- or extrahepatic lesions were detected. Considering that the patient had achieved down-staging of HCC, additional transarterial chemoembolization and radiofrequency ablation (RFA) were performed. The patient is currently alive without recurrence at 10 months after RFA. In conclusion, FDG-PET/CT is useful not only for the detection of extrahepatic metastasis, but also for the assessment of systemic chemotherapy in patients with advanced HCC.
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Short Communications
  • A new risk estimation scale of HCC development, named JAB-HCC score (Japanese risk estimations of HBV-related HCC), shows a good discrimination capability
    Tetsuya Hosaka, Fumitaka Suzuki, Masahiro Kobayashi, Yushi Sorin, Hide ...
    2015 Volume 56 Issue 9 Pages 477-481
    Published: September 20, 2015
    Released on J-STAGE: October 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.477
    JOURNAL FREE ACCESS
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    Chronic hepatitis B virus (HBV) infection leads to cirrhosis and hepatocellular carcinoma (HCC). However, the risk of HCC in each patient is non-uniform. We newly created an easy-to-calculate risk estimation scale of HCC in Japanese untreated chronic hepatitis B (CHB) patients. Our hospital-based cohort (n=1143) in which no patients received antiviral therapy was used to generate a risk scale of HCC development. We generated a new risk scale of HCC development based on the results of Cox regression analysis. Multivariate Cox model showed that predictive factors of HCC development were age, gender, preexisting cirrhosis, ALT, AFP, platelet count, HBeAg, and HBVDNA. Projected HCC risk score is sum total of each risk score in these nine parameters (range 0-24).
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  • A case of chronic hepatitis B detectable a entecavir resistance mutation (rtA186T)
    Keisuke Amano, Yasuhito Tanaka, Sanae Hayashi, Reiichiro Kuwahara, Kei ...
    2015 Volume 56 Issue 9 Pages 482-484
    Published: September 20, 2015
    Released on J-STAGE: October 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.482
    JOURNAL FREE ACCESS
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    Entecavir was approved as a drug for chronic hepatitis B. However, hepatitis B virus (HBV) may acquire drug resistance. For entecavir (drug) resistance (ETVr), another mutation (rt184, rt202, or rt250) must be acquired in addition to lamivudine (LAM)-resistant mutations (rtL180M and rtM204V). We performed HBV DNA sequencing in a LAM-resistant patient with viral breakthrough after the administration of entecavir for 27 months. In this patient, previously-reported ETVr mutants at the position of rt184, rt202, or rt250 were not found, but a mutation rtA186T was observed with LAM resistance (rtL180M and rtM204V). As it is difficult to evaluate rtA186T mutation using commercially available assays in Japan, it would be important to recognize it as a new resistant mutation.
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