Hepatic cysts are asymptomatic, rarely leading to complications such as infection. Here, we retrospectively reviewed comorbidities, biochemical and cyst fluid culture results, and treatment outcomes in a cohort of 31 patients diagnosed with hepatic cysts between 2014 and 2024 in our hospital. Comorbid biliary tract diseases were present in 8 (25.8%) patients. The cyst fluid was cultured in 27 patients, with positive results found 12 (44.4%) patients. The most common pathogen was Escherichia coli in 6 patients. Blood cultures were submitted in 30 patients; positive cultures were found in 5 (16.6%) patients and were associated with bacteremia in all patients. Antimicrobial agents were administered in all patients, and single and continuous drainage were performed in 8 and 19 patients, respectively. All patients were discharged from the hospital after recovery. Percutaneous drainage in addition to antibiotics was considered effective for treatment of infected hepatic cysts.

A 70-year-old man with alcoholic cirrhosis and diabetes mellitus was referred to our hospital for multiple hepatocellular carcinoma and achieved partial response after four courses of combination therapy with atezolizumab and bevacizumab. However, he developed fever with a blood oxygen saturation of 88% after 16 courses. Computed tomography imaging revealed peripheral ground-glass opacities and reticular shadows in both lungs. Real-time polymerase chain reaction revealed positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to the diagnosis of coronavirus disease 2019. After 12 days of treatment with remdesivir, fever resolved and he was negative for SARS-CoV-2 by real-time polymerase chain reaction. Peripheral abnormal shadows in bilateral lungs had also improved. However, he developed fever on day 14 and bronchoalveolar lavage on day 28 revealed numerous T lymphocytes, leading to the diagnosis of lung injury, a grade-3 immune-related adverse event. Steroid pulse therapy improved fever and ground-glass opacities at evaluation on day 34.

This is the case of a female patient in her 20s with hyperbilirubinemia (predominant conjugated bilirubin) detected since childhood. The patient was diagnosed with asymptomatic jaundice and was kept under observation.The patient was referred to our hospital because of an enlarged gallbladder polyp revealed on abdominal ultrasonography during follow-up and a pancreaticobiliary maljunction detected on magnetic resonance cholangiopancreatography. Laparoscopic cholecystectomy revealed a black liver. Pathological analysis of laparoscopic liver biopsy revealed lipofuscin-like pigment granules within hepatocytes, and immunohistochemical staining revealed that ATP-binding cassette subfamily C member 2 (ABCC2) protein was not stained, leading to the diagnosis of Dubin-Johnson syndrome. We report a case of Dubin-Johnson syndrome combined with pancreaticobiliary maljunction.

The present study assessed the roles and activities of hepatitis medical care coordinators (HMCCs) in regional core center hospitals through three surveys conducted in 2019, 2021, and 2023, revealing a working rate of 80%, with an increase observed in deployment to nonspecialist departments. The third survey including 27 hospitals revealed that 73.1% of the 1485 trained HMCCs were active, with a retention rate of 90% and an increasing rate of HMCC deployment to nonspecialist departments. New HMCC activities beyond those included in the Ministry of Health, Labor, and Welfare guidelines were also reported, such as educational efforts and the prevention of hepatitis B virus reactivation. These results highlight the importance of expanding the HMCC roles to increase motivation and efficacy and suggest that formalizing new activities in official notifications would support these goals.