A case of hepatocellular carcinoma associated with autoimmune hepatitis

We report a case of hepatocellular carcinoma (HCC) associated with autoimmune hepatitis in an 80-year-old female. The patient exhibited the presence of a liver injury 10 years previously. However, because the etiology was not identified, she did not receive specific treatment such as glucocorticoid therapy. She was admitted to our hospital because of the presence of a mass lesion in the S-8 region of the liver detected by ultrasonography. Serum alanine and aspartate aminotransferase levels were elevated and the serum gamma-globulin level was increased to more than 2.5 g/dl. Serum autoantibodies such as antinuclear antibody and anti-DNA antibody were positive. Hepatitis virus markers and their genes for hepatitis B virus (HBV) and hepatitis C virus (HCV) were negative in the serum. The biopsied specimen from the non-tumorous lesion showed a marked infiltration of chronic inflammatory cells, particularly plasma cells, and the tumorous lesion was well to moderately differentiated HCC. HBV DNA and HCV RNA were not detected in the tissue specimen from the non-tumorous lesion. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.