Hiroyuki Komoriyama

Primary squamous cell carcinoma of the liver: a case report.

BACKGROUND Bile cytology from percutaneous transhepatic cholangio-drainage (PTCD) is a useful procedure in case of obstructive jaundice. CASE Repeated cytology via PTCD from a cystically dilated duct in a 56-year-old female with a long clinical history permitted a diagnosis of squamous cell carcinoma (SCC). The smears showed excessive benign-appearing squamous cells with or without a nucleus and a few keratinized- and nonkeratinized-type SCC cells. No adenocarcinoma-derived cells were identified. No focus of SCC was detected clinically. The resected hepatic specimen disclosed a keratinized-type SCC simultaneous with benign metaplastic squamous epithelium. CONCLUSION This case of cytology of primary SCC of the liver seems to be the first reported. Even when showing a great number of benign-appearing squamous cells, the possibility of malignancy should not be ruled out. Repeating the cytology from PTCD is effective for a diagnosis.

Clinical Studies of Spontaneous Rupture of the Esophagus

The incidence of spontaneous rupture of the esophagus (Boerhaave’s syndrome) is rare, and identification of the disease is considered to be the first step in early treatment. In Japan, the site is the left wall of the lower esophagus in 90% of cases of esophageal rupture. We have experienced five patients (including one autopsied case) with this disease; two of the patients had a rupture on the right side. Three of these patients were cured by resection of the ruptured esophagus.

Giant Extrahepatic Hepatocellular Carcinoma. Report of Three Cases.

肝外発育型肝癌は比較的まれな疾患であり, その発生機序についてはいまだ明らかでない.また診断, 治療についても通常の肝癌と趣を異にする.われわれは3例の肝外発育型肝癌を経験した.症例1は38歳女で有茎型で, 肝実質は正常であった.肝部分切除後4年9か月健存している.症例2は39歳女で有茎型で, 慢性肝炎を併存していた.肝部分切除後2年8か月健存している.症例3は61歳男で肝外突出型で肝内転移があり, 肝硬変を併存していた.肝外側区域切除後7か月で死亡した.診断には超音波検査, computed tomography検査, 腫瘍マーカーが参考になり, 血管造影による栄養血管の確認が最も良いと思われた.治療は有茎型は小範囲の肝切除で予後は良好である.一方, 肝外突出型は通常の肝癌と同様必ずしも予後は良好とはいえない.