title: Hepatocellular carcinoma occurring in a Crohn's disease patient.
abstract: We report a case of hepatocellular carcinoma (HCC) occurring in a patient with Crohn's disease (CD) without chronic hepatitis or liver cirrhosis, and review the clinicopathological features of HCC in CD patients. A 37-year-old Japanese man with an 8-year history of CD and a medication history of azathioprine underwent resection of a liver tumor. The histopathology of the liver tumor was pseudoglandular type HCC. In the non-neoplastic liver, focal hepatocyte glycogenosis (FHG) was observed, however, there was no evidence of liver cirrhosis or primary sclerosing cholangitis. Only nine cases of HCC in CD patients have been reported previously in the English-language literature. Eight of 10 cases (including the present case) had received azathioprine treatment, and four of these cases also showed FHG, which is considered a preneoplastic liver lesion, within the non-neoplastic liver. Although the precise mechanism of the development of HCC in CD patients is controversial, these results suggest that azathioprine therapy and FHG in the non-neoplastic liver contribute to the development of HCC. These findings also indicate that it is important to survey CD patients treated with prolonged azathioprine therapy for potential liver tumors.
authors.affiliation: Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan. mitsuaki@belle.shiga-med.ac.jp
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Ishida
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Naka
authors.forename: Hisanori
authors.initials: H
authors.lastname: Shiomi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsujikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Andoh
authors.forename: Tamio
authors.initials: T
authors.lastname: Nakahara
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Saito
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kurumi
authors.forename: Mikiko
authors.initials: M
authors.lastname: Takikita-Suzuki
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Kojima
authors.forename: Machiko
authors.initials: M
authors.lastname: Hotta
authors.forename: Tohru
authors.initials: T
authors.lastname: Tani
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Fujiyama
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Okabe
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D008297:Male; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine