Ikura Y, Nagatomi N, Ohtani K, Harihara S, Yamamoto T, Kuwahara H, Sakurai M
Department of Pathology, Osaka City University Medical School, Japan.
Gastroenterol Jpn. 1993 Aug;28(4):564-9. doi: 10.1007/BF02776956.
An 81-year-old woman in whom liver dysfunction had been pointed out 3 years previously was diagnosed as having liver cirrhosis due to lupoid hepatitis. Considering the poor prognosis of cirrhosis and her age, immunosuppressive therapy was not adopted. Nine months later, a small liver tumor was found by ultrasonography and was diagnosed as hepatocellular carcinoma (HCC). The tumor was treated with transcatheter arterial embolization, but grew continuously. She also developed gingival lymphoma that was successfully treated. Three years after initial diagnosis of lupoid hepatitis, she died of hepatic failure. An autopsy was performed and confirmed the clinical diagnosis, liver cirrhosis with HCC. HCC is regarded as a rare complication of lupoid hepatitis, but cases of HCC complicating lupoid hepatitis may increase with progress in treatment methods and elongation of survival. The present case suggests that any malignancy can be developed in long-term surviving patients with lupoid hepatitis.
一名81岁女性，3年前被指出存在肝功能障碍，因狼疮样肝炎被诊断为肝硬化。考虑到肝硬化预后不佳及患者年龄，未采用免疫抑制治疗。9个月后，超声检查发现一个小肝脏肿瘤，被诊断为肝细胞癌（HCC）。该肿瘤接受了经导管动脉栓塞治疗，但持续生长。她还患上了牙龈淋巴瘤，经治疗成功缓解。狼疮样肝炎初诊3年后，她死于肝衰竭。进行了尸检，证实了临床诊断，即伴有HCC的肝硬化。HCC被视为狼疮样肝炎的一种罕见并发症，但随着治疗方法的进步和生存期的延长，狼疮样肝炎并发HCC的病例可能会增加。本病例提示，长期存活的狼疮样肝炎患者可能会发生任何恶性肿瘤。
