We prospectively analyzed controlled attenuation parameter (CAP), liver stiffness (LS), and FibroScan-AST (FAST) scores of nonalcoholic fatty liver disease (NAFLD) in 396 patients by transient elastography (TE). Informed consent was collected from 116 patients who participated in the study, and was evaluated by TE every year. Statistically important progressive factors of NAFLD patients to death, liver cirrhosis (LC), hepatocellular carcinoma (HCC), and cardiovascular disease were FAST score, FAST score, body weight ratio and diabetes mellitus, respectively. The most significant determinant in NAFLD patients' progression to LC was their FAST score. Worse LS was identified in the progression to LC; thus, LS follow-up is crucial. Two patients that progressed to HCC without LC were identified.

A male patient in his 50s who complained of general malaise, itchy skin, and brown urine was admitted to our hospital. Both hepatitis virus markers and autoantibodies were negative. He developed a rash that appeared on his limbs and trunk, a thorough history revealed two months of contact with the sex business, raising the possibility of syphilis infection. Early-stage syphilis (stage 2) and early-stage syphilitic hepatitis were determined to exist. A single-dose benzylpenicillin benzathine hydrate (BPB) intramuscular injection, newly available in Japan since January 2022, and suitable for early treatment of syphilis, was administered. The rash and liver failure and syphilis were all quickly resolved. Although uncommon, early-stage syphilitic hepatitis should be taken into account as a possible cause of liver damage. No earlier publications have used intramuscular BPB injection as a treatment for early-stage syphilitic hepatitis in Japan, hence we present this case together with a literature review.

We describe a case of a woman in her 40s who underwent a medical examination and discovered a 15-cm large mass protruding from her liver. Although her medical history or liver background was unremarkable and tumor markers were normal, contrast-enhanced CT revealed a 15-cm-sized tumor in the right lobe of the liver with an early arterial phase and a washout in the delayed phase. The EOB-MRI revealed the tumor was represented as a defect, and hepatocellular carcinoma was strongly suspected. Given the potential for rupture, TACE was carried out first. An extensive right hepatic lobectomy was then carried out. Histopathological analysis revealed that the tumor was primarily made up of smooth muscle-like cells without any adipocytes, and immunohistochemical staining was positive for Vimentin and αSMA, and HMB-45 and MelanA. Therefore, we determined that the patient has a myomataous type of hepatic angiomyolipoma.