The association between the actual status of cryoglobulins (CGs) expression in hepatitis C-related chronic liver disease (C-CLD) and different types of liver pathology, HCV-RNA titers and genotypes was investigated. Sixteen out of 1340 ordinary clinical specimens were CGs-positive (1%), and in 8 of them (50%) the patients blood was HCV-RNA positive. CGs was detected in 63% of C-CLD patients as a whole, but when compared with the histological findings in the liver, it was 88% in F3, and 92% in A3, and thus high percentages were detected in patients with progression of liver fibrosis and patients with strong activity. Serum IgG, IgM, transaminase and γ-GTP levels were significantly higher in the patients with CGs, and their RA test and C3dCIC levels tended to be higher, but the differences were not significant, and no association was found with the anti-nuclear antibody positive level, or the HCV-RNA titers or genotypes. Based on the above, there was a clear involvement of HCV infection, especially the activity and histological progression of hepatitis in CGs formation in Japan as well, but there were few extrahepatic manifestations, suggesting differences in CGS levels and immune response to CGs from cases in Western countries.
EUS between neoplasms and non-neoplasms. The characteristic findings of neoplasms were a nodular or smooth contour and a solid internal echo, while those of non-neoplasms were a granular contour and a spotty internal echo. The contour shown by EUS especially well reflected the gross appearance. Assessment of the contour of lesions was the most reliable in differential diagnosis between neoplasms and non-neoplasms, for example, I p-type carcinomas and large cholesterol polyps ; such differential diagnosis is clinically important. It was thought to be reasonable to establish a diagnostic criteria based on EUS findings : if the contour of a lesion is smooth or nodular, the lesion is classified as a neoplasm, and if the contour of a lesion is granular, the lesion is diagnosed as a non-neoplasm.