Kim SR, Ikawa H, Ando K, Mita K, Fuki S, Sakamoto M, Kanbara Y, Matsuoka T, Kudo M, Hayashi Y. Multistep hepatocarcinogenesis from a dysplastic nodule to well-differentiated hepatocellular carcinoma in a patient with alcohol-related liver cirrhosis. World J Gastroenterol 2007; 13(8): 1271-1274 [PMID: 17451213 DOI: 10.3748/wjg.v13.i8.1271]
Corresponding Author of This Article
Soo Ryang Kim, MD, Department of Gastroenterology, Kobe Asahi Hospital, 3-5-25 Bouoji-cho, Nagata-ku, Kobe 653-0801, Japan. info@kobe-asahi-hp.com
Article-Type of This Article
Case Report
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World J Gastroenterol. Feb 28, 2007; 13(8): 1271-1274 Published online Feb 28, 2007. doi: 10.3748/wjg.v13.i8.1271
Multistep hepatocarcinogenesis from a dysplastic nodule to well-differentiated hepatocellular carcinoma in a patient with alcohol-related liver cirrhosis
Soo Ryang Kim, Hirotsugu Ikawa, Kenji Ando, Keiji Mita, Shuichi Fuki, Department of Gastroenterology, Kobe Asahi Hospital, Japan
Michiie Sakamoto, Department of Pathology, Keio University School of Medicine, Japan
Yoshihiro Kanbara, Department of Surgery, Hyogo Medical Center for Adults, Japan
Toshiyuki Matsuoka, Department of Radiology, Osaka City University Medical School, Japan
Masatoshi Kudo, Department of Gastroenterology, Kinki University School of Medicine, Japan
Yoshitake Hayashi, Division of Molecular Medicine & Medical Genetics, International Center for Medical Research and Treatment, Kobe University Graduate School of Medicine, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Soo Ryang Kim, MD, Department of Gastroenterology, Kobe Asahi Hospital, 3-5-25 Bouoji-cho, Nagata-ku, Kobe 653-0801, Japan. info@kobe-asahi-hp.com
Telephone: +81-78-6125151 Fax: +81-78-6125152
Received: November 17, 2006 Revised: December 20, 2006 Accepted: January 29, 2007 Published online: February 28, 2007
Abstract
We describe a rare case of the transformation of a dysplastic nodule into well-differentiated hepato-cellular carcinoma (HCC) in a 56-year-old man with alcoholrelated liver cirrhosis. Ultrasound (US) disclosed a 10 mm hypoechoic nodule and contrast enhanced US revealed a hypovascular nodule, both in segment seven. US-guided biopsy revealed a high-grade dysplastic nodule characterized by enhanced cellularity with a high N/C ratio, increased cytoplasmic eosinophilia, and slight cell atypia. One year later, the US pattern of the nodule changed from hypoechoic to hyperechoic without any change in size or hypovascularity. US-guided biopsy revealed well-differentiated HCC of the same features as shown in the first biopsy, but with additional pseudoglandular formation and moderate cell atypia. Moreover, immunohistochemical staining of cyclase-associated protein 2, a new molecular marker of well-differentiated HCC, turned positive. This is the first case of multistep hepatocarcinogenesis from a dysplastic nodule to well-differentiated HCC within one year in alcohol-related liver cirrhosis.
