Clinicopathological study of hepatic nodular lesions in patients with alcoholic liver cirrhosis.
BACKGROUND
There have been few reports concerning the occurrence of hepatocellular carcinoma (HCC) in heavy drinkers not sensitized by hepatitis B virus (HBV) or hepatitis C virus. With current advances in diagnostic methods, hypervascular tumors are often discovered on imaging findings in alcoholics, and it is important to differentiate them from HCCs.


METHODS
The subjects were 16 alcoholics who had hepatic nodules and were hepatitis B surface antigen negative and hepatitis C virus antibody negative and were classified into two groups: (1) the HBV group with hepatitis B surface antibody and/or hepatitis B core antibody and (2) the alcoholic group without these antibodies. Computed tomography (CT), magnetic resonance imaging, and tumor biopsy were conducted for all subjects, and digital subtraction angiography or CT during arterial portography and CT during arteriography were performed for all but one case.


RESULTS
In the alcoholic group, there were no significant differences in the clinical features between the presence and absence of HCC. All nodules in the HBV group were HCCs, whereas in the alcoholic group, 6 of 16 lesions were HCCs and the others were hyperplastic nodules. Limited to the hypervascular tumors in the alcoholic group, on magnetic resonance imaging T1-weighted images, hyperplastic nodules showed hyperintensity, whereas HCCs were iso- or hypointense.


CONCLUSIONS
HCCs can occur at a high rate in alcoholics, especially in those with HBV-associated antibodies. The patients with alcoholic liver cirrhosis sometimes have hypervascular tumors that are not cancer but hyperplastic nodules, and care must be taken in their treatment.
Sobue
Satoshi
S
Department of Internal Medicine and Bioregulation, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ssobue@med.nagoya-cu.ac.jp
Nomura
Tomoyuki
T
Nakao
Haruhisa
H
Mizuno
Yaichi
Y
Nojiri
Syunsuke
S
Kanematsu
Takayoshi
T
Senda
Katsuhiro
K
Murasaki
Gengo
G
Itoh
Makoto
M
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008104:Liver Cirrhosis, Alcoholic / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged