Hepatocellular carcinoma with nonalcoholic steatohepatitis |
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Authors: | Sayaka Mori Takahiro Yamasaki Isao Sakaida Taro Takami Eiki Sakaguchi Teruaki Kimura Fumie Kurokawa Shiro Maeyama Kiwamu Okita |
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Institution: | (1) Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan;(2) Department of Internal Medicine, Yamaguchi Rosai Hospital, Onoda, Japan;(3) Department of Bioregulatory Function, Yamaguchi University School of Medicine, Ube, Japan;(4) Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan |
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Abstract: | Nonalcoholic steatohepatitis (NASH) was originally believed to be a benign disease. However, it has been recently revealed that NASH could lead to irreversible liver disease in some patients. We report an unusual case of hepatocellular carcinoma (HCC) in a 76-year-old man with NASH. He had no history of alcohol consumption, drug use, or blood transfusion. He was negative for all serological viral markers and autoantibodies. In addition, he was obese (body mass index BMI], 30.75kg/m2) and had type 2 diabetes mellitus. A liver biopsy specimen showed moderate steatosis with necroinflammatory changes, ballooning degeneration, Mallory bodies, pericellular fibrosis, and evidence of nodular regeneration. He was diagnosed with NASH with cirrhosis. Simultaneously, a liver tumor, measuring 19mm in diameter, was detected in segment 6. A tumor biopsy specimen revealed well-differentiated HCC, and imaging modalities confirmed the characteristics of HCC. To our knowledge, ten patients who had HCC with NASH were reported. In all patients with NASH and HCC, cirrhosis was present. Patients with NASH and cirrhosis may progress to HCC, and regular screening, based on tumor markers and imaging modalities, is needed to detect HCC in patients with NASH and cirrhosis. |
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Keywords: | nonalcoholic steatohepatitis hepatocellular carcinoma cirrhosis obesity diabetes mellitus |
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