Taniguchi Hideaki, Shibagaki Koutaro, Seshimo Ken, Kobayashi Keita
Department of Internal Medicine (Gastroenterology), Tottori Municipal Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2012 Apr;109(4):630-7.
A 50-year-old man with a history of alcohol intake exceeding 80 g/day was admitted because of severe liver dysfunction and high fever. A rapid increase of transaminase with remittent high fever was observed several days after admission. Abdominal CT scan demonstrated a 22×20 mm mass in segment 8, highly suggestive of hepatocellular carcinoma. However, because the etiology of the liver dysfunction was still unknown, we performed a liver biopsy on the sixth day. Histological examination of the liver specimen showed marked granulocyte infiltration, Mallory bodies, and hepatocyte ballooning, all consistent with alcoholic hepatitis. We made a final diagnosis of alcoholic hepatitis and successfully treated him with corticosteroids. This case suggests that a liver biopsy has diagnostic value in alcoholic hepatitis, especially in cases in which the diagnosis is uncertain.
一名50岁男性，有每日酒精摄入量超过80克的病史，因严重肝功能不全和高热入院。入院几天后观察到转氨酶迅速升高并伴有弛张热。腹部CT扫描显示肝8段有一个22×20毫米的肿块，高度提示肝细胞癌。然而，由于肝功能不全的病因仍不清楚，我们在第六天进行了肝活检。肝标本的组织学检查显示有明显的粒细胞浸润、马洛里小体和肝细胞气球样变，均符合酒精性肝炎。我们最终诊断为酒精性肝炎，并成功地用皮质类固醇对他进行了治疗。该病例表明肝活检对酒精性肝炎具有诊断价值，尤其是在诊断不确定的情况下。
