title: [Primary hepatic actinomycosis concomitant with elevation of protein induced by vitamin K absence or antagonist II - report of a case].
abstract: We report a case of primary hepatic actinomycosis showing elevation of serum protein induced by vitamin K absence or antagonist II (PIVKA-II). A 68-year-old man visited an affiliated hospital with a complaint of high fever and body weight loss. Hematological examination revealed severe inflammatory reactions and liver dysfunction. Abdominal CT showed a heterogeneous low density area composed of cystic and solid part. We suspected the cystic part with band-like enhancement to be a hepatic abscess and performed percutaneous transhepatic abscess drainage. Although inflammatory reactions decreased after the drainage, the solid part did not shrink and blood chemistry revealed elevation of PIVKA-II. Since we could not rule out the possibility of hepatoma, right hepatectomy was performed. Histological examination revealed actinomycetes. Although primary hepatic actinomycosis is a rare disease, it must be kept in mind in the differential diagnosis of the liver tumor.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine. yoshi-mo@hana-med.ac.jp
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Morita
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shibasaki
authors.forename: Kosuke
authors.initials: K
authors.lastname: Oishi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Inaba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Baba
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.forename: Shohachi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Okai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D000196:Actinomycosis / Q000097:blood* / Q000175:diagnosis; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D003937:Diagnosis, Differential; D006801:Humans; D008107:Liver Diseases / Q000097:blood* / Q000175:diagnosis; D008113:Liver Neoplasms / Q000175:diagnosis; D008297:Male; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin