title: Hepatocellular carcinoma with nonalcoholic steatohepatitis.
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], 30.75 kg/m(2)) 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 19 mm 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.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube 755-8505, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Mori
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
authors.forename: Taro
authors.initials: T
authors.lastname: Takami
authors.forename: Eiki
authors.initials: E
authors.lastname: Sakaguchi
authors.forename: Teruaki
authors.initials: T
authors.lastname: Kimura
authors.forename: Fumie
authors.initials: F
authors.lastname: Kurokawa
authors.forename: Shiro
authors.initials: S
authors.lastname: Maeyama
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis; D008297:Male; D009765:Obesity