title: [Two cases of patients with hepatocellular carcinoma (HCC) that developed in cryptogenic cirrhosis suggestive of nonalcoholic steatohepatitis (NASH) as background liver disease after clinical courses of 26 years].
abstract: We report two cases of patients with hepatocellular carcinoma (HCC) that developed in cryptogenic cirrhosis suggestive of nonalcoholic steatohepatitis (NASH) as background liver disease. Case 1 was a 68-year-old woman, and case 2 was a 46-year-old man. They were admitted to our department for evaluation and treatment of HCC. The causes of the underlying liver disease were not determined from blood tests. However, histological analysis of non-tumor tissues of the liver revealed cirrhosis with few fat droplets. Both patients had undergone liver biopsy 26 years before the treatment of HCC. Histological review of the biopsy specimens revealed NASH (case 1) and fatty liver (case 2), respectively. It was suggested that these cases progressed from NASH and fatty liver, respectively, to NASH-related cirrhosis (so called burned-out NASH), eventually, developing HCC. These findings suggest that substantial number of burned-out NASH cases may be included in those with cryptogenic cirrhosis. These two patients are indicative cases that may reveal the long-term natural course of fatty liver and NASH.
authors.affiliation: Department of Gastroenterology, Iwaki Kyoritsu General Hospital, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tsutsumi
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakayama
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sakai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kojima
authors.forename: Naohiro
authors.initials: N
authors.lastname: Dairaku
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ojima
authors.forename: Masao
authors.initials: M
authors.lastname: Kusano
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ikeya
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sugai
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hiwatashi
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000473:pathology; D005218:Fat Necrosis / Q000150:complications* / Q000473:pathology; D005234:Fatty Liver / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013997:Time Factors