title: [Case of moderately differentiated hepatocellular carcinoma with gastric metastasis].
abstract: A solitary liver nodule about 1cm in diameter was detected in a 68-year-old male HBV carrier during therapy for advanced lung cancer. A multiple IIc-like depressed lesion originating in the stomach soon became elevated as the liver lesion progressed. HE staining produced hepatoma-like histological findings for the tumors of the lung, liver and stomach, while immunohistochemical staining showed them to be positive for PIVKA-II and weakly positive for HP-1. Autopsy led to a diagnosis of a moderately differentiated hepatocellular carcinoma producing bile juice with metastasis to the lung and stomach. It is not clear why advanced metastasis in the lung occurred while the hepatocellular carcinoma in the liver was still small, but one possible explanation lies in the localization of the hepatic cancer: the tumor was located near a branch of the hepatic vein and vascular invasion may have caused early pulmonary metastasis via the hepatic venous flow.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital.
authors.forename: Kiyoaki
authors.initials: K
authors.lastname: Hatano
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kita
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Hiroo
authors.initials: H
authors.lastname: Matsuo
authors.forename: Norihiro
authors.initials: N
authors.lastname: Nishijima
authors.forename: Sumio
authors.initials: S
authors.lastname: Saito
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Ikeda
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nasu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishikawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ohtsuru
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tuji
authors.forename: Takehiko
authors.initials: T
authors.lastname: Tsumura
authors.forename: Takanori
authors.initials: T
authors.lastname: Maruo
authors.forename: Toru
authors.initials: T
authors.lastname: Kimura
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shintaku
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D003952:Diagnostic Imaging; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary; D008297:Male; D011498:Protein Precursors / Q000032:analysis; D011516:Prothrombin / Q000032:analysis; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin