Miyaaki Hisamitsu, Ichikawa Tatsuki, Taura Naota, Yamashima Mio, Arai Hideyuki, Obata Yoko, Furusu Akira, Hayashi Hiroko, Kohno Shigeru, Nakao Kazuhiko
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Intern Med. 2010;49(14):1383-6. doi: 10.2169/internalmedicine.49.3296. Epub 2010 Jul 15.
A 62-year-old female was admitted for examination of an abnormal liver function. Plain CT and MRI of the abdomen showed marked hepatomegaly but no visible nodular lesion in the liver. On the 3rd hospital day she had hepatic encephalopathy and was treated with a course of high-dose steroids, but ultimately died of disease progression on the 7th hospital day. An autopsy revealed a small pulmonary nodule with the histological findings showing small cell carcinoma. There was almost complete parenchymal replacement with metastatic tumor in the liver. Neoplastic involvement of the liver should be considered in the differential diagnosis of fulminant hepatic failure of unknown etiology.
一名62岁女性因肝功能异常入院检查。腹部平扫CT和MRI显示肝脏明显肿大，但肝脏内未见明显结节性病变。入院第3天，她出现肝性脑病，接受了一个疗程的大剂量类固醇治疗，但最终在入院第7天因疾病进展死亡。尸检发现一个小的肺结节，组织学检查显示为小细胞癌。肝脏几乎完全被转移性肿瘤实质替代。在不明原因的暴发性肝衰竭的鉴别诊断中应考虑肝脏的肿瘤性累及。
