Hepatocellular carcinoma arising in non-alcoholic steatohepatitis.
The incidence and significance of hepatocellular carcinoma (HCC) in non-alcoholic steatohepatitis (NASH) has not been previously evaluated in detail. We recently experienced a case of NASH with multicentric HCC in a female patient. At the age of 58 years, the patient was diagnosed with non-insulin-dependent diabetes mellitus, treated by insulin therapy. The patient did not drink alcohol. She was negative for all serological markers of hepatitis B and C virus infection. Because of liver dysfunction, a needle biopsy was performed at the age of 62 years, and pathological findings, such as fatty change, Mallory's body, nuclear glycogen and pericellular fibrosis, suggested a diagnosis of NASH. Subsequently, four nodules were detected in the liver by imaging. Liver biopsies were performed from each nodule. One nodule was pathologically diagnosed as a pseudolymphoma, while three other nodules were moderately differentiated HCC (10 years after the diagnosis of non-alcoholic steatohepatitis), well-differentiated HCC (11 years later) and dysplastic nodule (11 years later), suggesting multicentric occurrence of HCC. This case suggests that HCC could be a late complication of NASH.
Zen
Y
Y
Second Department of Pathology, Department of Internal Medicine, Asanogawa General Hospital, Kanazawa, Japan.
Katayanagi
K
K
Tsuneyama
K
K
Harada
K
K
Araki
I
I
Nakanuma
Y
Y
D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology; D005234:Fatty Liver / Q000150:complications* / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000150:complications* / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged