Ishida M, Naka S, Shiomi H, Tsujikawa T, Andoh A, Nakahara T, Saito Y, Kurumi Y, Takikita-Suzuki M, Kojima F, Hotta M, Tani T, Fujiyama Y, Okabe H. Hepatocellular carcinoma occurring in a Crohn’s disease patient. World J Gastroenterol 2010; 16(25): 3215-3218 [PMID: 20593510 DOI: 10.3748/wjg.v16.i25.3215]
Corresponding Author of This Article
Mitsuaki Ishida, MD, PhD, Assistant Professor, 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
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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Mitsuaki Ishida, Mikiko Takikita-Suzuki, Fumiyoshi Kojima, Machiko Hotta, Hidetoshi Okabe, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Shigeyuki Naka, Hisanori Shiomi, Yoshimasa Kurumi, Tohru Tani, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Tomoyuki Tsujikawa, Akira Andoh, Tamio Nakahara, Yoshihide Fujiyama, Department of Gastroenterology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Yasuharu Saito, Division of Endoscopy, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Author contributions: Ishida M interpreted the data; Ishida M and Okabe H wrote the manuscript; all authors contributed to analyzing the patient’s data.
Correspondence to: Mitsuaki Ishida, MD, PhD, Assistant Professor, 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
Telephone: +81-77-5482603 Fax: +81-77-5482407
Received: March 4, 2010 Revised: March 30, 2010 Accepted: April 6, 2010 Published online: July 7, 2010
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.
