Hepatocellular carcinoma occurring in a Crohn's disease patient.
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.
Ishida
Mitsuaki
M
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
Naka
Shigeyuki
S
Shiomi
Hisanori
H
Tsujikawa
Tomoyuki
T
Andoh
Akira
A
Nakahara
Tamio
T
Saito
Yasuharu
Y
Kurumi
Yoshimasa
Y
Takikita-Suzuki
Mikiko
M
Kojima
Fumiyoshi
F
Hotta
Machiko
M
Tani
Tohru
T
Fujiyama
Yoshihide
Y
Okabe
Hidetoshi
H
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
D007166:Immunosuppressive Agents; D001379:Azathioprine