A Resected Case of Well-differentiated Hepatocellular Carcinoma, 45mm in Diameter with Remarkable Fatty Change

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  • KOGA Hiroyuki
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • TAGUCHI Jun
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • IEMURA Akihiro
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • KAJIWARA Masahiko
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • INOUE Kinya
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • ISHIBASHI Akiko
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • KUBOYAMA Shin-ichi
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • ISHII Kunihide
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • ABE Hirohiko
    Department of Internal Medicine, Fukuoka Prefectural Hepato-gastroenterological center
  • TUJI Yoshiaki
    Department of Surgery, Fukuoka Prefectural Heapato-gstroenterological center
  • NAKASHIMA Osamu
    First Department of Pathology, Kurume University, School of Medicine
  • KOJIRO Masamichi
    First Department of Pathology, Kurume University, School of Medicine
  • HARADA Riko
    Second Department of Internal Medicine, Kurume University, School of Medicine
  • SATA Michio
    Second Department of Internal Medicine, Kurume University, School of Medicine

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Other Title
  • 著明な脂肪化を呈した腫よう径４５ｍｍの高分化型肝細胞癌の１切除例

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Abstract

著明な脂肪化を呈した腫瘍径45mmの高分化型肝細胞癌の1切除例を経験した. 症例は82歳, 女性. 非B非C型慢性肝炎例で, 腹部超音波 (US) にて肝後区域に長径約45mmの高エコーを呈する類円形の腫瘤を認めた. 腹部CTでは同部位に低吸収域を認め, 造影CTでは造影早期相で腫瘤内部は淡染され, 造影後期相でも造影効果は持続していた. MRIはT1強調で不均一な高信号, T2強調で均一な高信号, ダイナミックで造影早期より淡染され, 造影後期で一部造影効果が持続していた. DSAによる血管造影では腫瘍濃染像を認めた. 肝切除後の病理組織所見では, 肉眼的に単結節で, 組織学的には腫瘍を構成する細胞の大部分は脂肪化を伴い索状配列を示す高分化型肝細胞癌であり, 非癌部肝は慢性肝炎の像を呈していた. 著明な脂肪化を伴った大型の高分化型肝細胞癌であり臨床病理学的に示唆に富む症例と考え報告した.

Journal

  • Kanzo

    Kanzo 43 (10), 459-464, 2002

    The Japan Society of Hepatology

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