Characteristic miR-24 Expression in Gastric Cancers among Atomic Bomb Survivors.

OBJECTIVE: To elucidate the mechanism of radiation-induced cancers, we analyzed the expression profiles of microRNAs extracted from formalin-fixed paraffin-embedded (FFPE) gastric cancer (GC) tissue samples from atomic bomb survivors. METHODS: The expression levels of miR-21, miR-24, miR-34a, miR-106a, miR-143, and miR-145 were measured by quantitative reverse transcription polymerase chain reaction (qRT-PCR). RESULTS: The expression of microRNAs was measured by qRT-PCR in a Hiroshima University Hospital cohort comprising 32 patients in the high-dose-exposed group and 18 patients in the low-dose-exposed group who developed GC after the bombing. The GC cases showing high expression of miR-24, miR-143, and miR-145 were more frequently found in the high-dose-exposed group than in the low-dose-exposed group. We next performed qRT-PCR of miR-24, miR-143, and miR-145 in a cohort from the Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital comprising 122 patients in the high-dose-exposed group and 48 patients in the low-dose-exposed group who developed GC after the bombing. High expressions of miR-24 and miR-143 were more frequently found in the high-dose-exposed group than in the low-dose-exposed group. Multivariate analysis demonstrated that only high expression of miR-24 was an independent predictor for the exposure status. CONCLUSION: These results suggest that the measurement of miR-24 expression from FFPE samples is useful to identify radiation-associated GC.

Blood transfusion is associated with recurrence of hepatocellular carcinoma after hepatectomy in Child-Pugh class A patients.

INTRODUCTION: Previous reports have indicated an association between blood transfusion and prognosis of hepatocellular carcinoma (HCC) after hepatectomy. However, clinicopathological biases were not adjusted in these studies. We aimed to clarify the effect of blood transfusions in patients with HCC and Child-Pugh class A after hepatectomy by using inverse probability of treatment weighting (IPTW) analysis for selection bias control. MATERIALS AND METHODS: We enrolled 479 patients with primary HCC and Child-Pugh class A retrospectively (91 transfused and 388 nontransfused patients) who underwent curative hepatectomy. After adjusting for different covariate distributions for both groups by IPTW, we analyzed the prognostic outcomes. RESULTS: In the unweighted analyses, overall survival (OS) rate of transfused patients was significantly lower than in nontransfused patients (P < 0.0001). Recurrence-free survival (RFS) rate of transfused patients was significantly lower than that of nontransfused patients (P = 0.0024). Multivariate analysis showed that blood transfusion was an independent prognostic factor of OS and RFS. The different distributive covariates between the two groups were age, presence of liver cirrhosis, serum level of alpha-fetoprotein, maximum tumor diameter, and amount of intraoperative blood loss. After IPTW by these covariates, OS rate of transfused patients was not significantly lower than those of nontransfused patients, whereas RFS rate of transfused patients remained significantly lower than those of nontransfused patients (P = 0.038, adjusted HR 1.45; 95% CI 1.0-2.1). CONCLUSIONS: These results suggest that blood transfusion was associated with recurrence of HCC after hepatectomy in patients with HCC and Child-Pugh class A.

Surgical Resection for Hepatocellular Carcinoma with Concomitant Esophageal Varices.

BACKGROUND: The management of hepatocellular carcinoma (HCC) in patients with concomitant esophageal varices (EV) remains controversial. We assessed the surgical outcome of hepatectomy and aimed to clarify the indications and management of HCC in patients with concomitant EV. METHODS: We retrospectively enrolled 502 patients with HCC (100 with and 402 without EV), who underwent curative hepatectomy. We analyzed the prognostic outcomes and risk factors for EV bleeding after hepatectomy. RESULTS: Overall survival (OS) was significantly lower in HCC patients with EV than in those without EV (p = 0.003), although recurrence-free survival was similar in both groups. Multivariate analysis showed that indocyanine green retention test at 15 min (ICGR15) >17 % (p = 0.007) and α-fetoprotein >12.5 ng/ml (p = 0.003) was independent predictors of poorer OS. Among patients with EV who underwent hepatectomy, multivariate analysis identified ICGR15 >17 % (p = 0.03) as the only independent predictor of poorer OS. There was no significant difference in OS between HCC patients with EV and ICGR15 ≤17.0 % and HCC patients without EV. Ten patients experienced EV bleeding after hepatectomy. Multivariate analysis showed that preoperative endoscopic findings of blue color EV (p = 0.008) and red color sign (p = 0.0005) were independent predictors of EV bleeding in patients with HCC after hepatectomy. CONCLUSIONS: These results suggest that HCC patients with EV and ICGR15 ≤17 % may be suitable for surgery, but patients with preoperative endoscopic blue color EV and red color sign need to be managed appropriately.

Effect of sustained virological response to interferon therapy for hepatitis C to the hepatectomy for primary hepatocellular carcinoma.

BACKGROUND/AIMS: Interferon (IFN) therapy improves the prognosis of the patients with HCV-related hepatocellular carcinoma (HCC). However, the effects of IFN therapy for hepatectomy (Hx) for primary HCC have not been established. Several published reports investigating the effects of IFN therapy on survival and tumor recurrence after curative resection of HCC have been inconclusive. METHODOLOGY: Subjects included 470 patients who underwent Hx for HCV related primary HCC. One hundred and fifty nine patients received IFN therapy past or postoperatively of the first Hx. Seventy-four of those patients attained a sustained viral response (SVR group). The other 396 patients, including 85 were no responders (NR) and 311 patients who had not received IFN therapy (non-IFN) were classified as the control group. RESULTS: Overall survival (SVR group vs. control group: 5-yr, 93.2 vs. 61.9%; p<0.0001) and disease-free survival (SVR group vs. control group: 5-yr, 56.0 vs. 27.4%; p<0.0001) rates were significantly different. By multivariate analysis, NR/non-IFN was the independent risk factor for overall survival (p=0.0002) and disease-free survival (p=0.0053) after Hx. CONCLUSIONS: SVR achieved past or postoperatively to the Hx of HCV-related HCC significantly inhibits recurrence and consequently improves patient survival after Hx for HCC.

Identification of the NEDD4L gene as a prognostic marker by integrated microarray analysis of copy number and gene expression profiling in non-small cell lung cancer.

PURPOSE: The purpose of this study was to identify prognostic genes by integrated microarray analysis between comparative genomic hybridization and gene expression with laser microdissection in non-small cell lung cancer (NSCLC). METHODS: Integrated microarray analysis in 11 lung adenocarcinomas was performed, and several genes were identified. Among them, neural precursor cell-expressed developmentally down-regulated 4-like (NEDD4L) was chosen for further characterization. Quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used to explore the clinicopathological significance of NEDD4L expression in 84 NSCLC patients. RESULTS: 18q was more frequently lost in advanced lung cancer. Therefore, we selected the NEDD4L gene, located on chromosome 18q, for which reduced expression was significantly correlated with copy number loss. NEDD4L mRNA expression in paired tumor/normal samples from 79 cases of lung cancer was evaluated using real-time PCR analysis. NEDD4L mRNA expression was significantly lower in tumor tissues than in normal lung tissues (p < 0.0001). Clinicopathological factors, such as excessive smoking history, histological grade (moderately and poorly), T stage (T2-4), lymph node metastasis, and pathological stage (stage II-IV), were significantly associated with low NEDD4L expression (p < 0.05). In the low expression group, prognoses were significantly poorer than in the high expression group (p < 0.05). CONCLUSIONS: Low NEDD4L expression may be a marker of prognosis. This is the first report to describe NEDD4L expression in NSCLC. NEDD4L may be considered a key gene in the progression of NSCLC, and its expression is likely affected by genomic alterations.

Outcome and status of microsatellite stability in Japanese atomic bomb survivors with early gastric carcinoma.

BACKGROUND: In the decade after the 1945 atomic bombing of Hiroshima, a high incidence of leukemia was observed among atomic bomb survivors. However, the incidence of other cancers gradually increased, while that of leukemia decreased after this period. We evaluated the clinical outcome of early gastric cancer and microsatellite stability over a long-term period in atomic bomb survivors. METHODS: The results of surgical treatment for early gastric cancer were reviewed for 117 atomic bomb survivors and 394 control patients between 1995 and 2006. In addition, immunohistochemical staining for hMSH2 and hMLH1 expression was performed to evaluate the status of microsatellite stability in 57 atomic bomb survivors and 82 control patients. RESULTS: The long-term survival rate for early gastric cancer in atomic bomb survivors was significantly lower than that in control patients (p < 0.01). Multivariable analysis revealed that age and sex were significant and independent prognostic factors for early gastric cancer. Defective hMSH2 and/or hMLH1 expression was also significantly higher in survivors than in control patients (p < 0.001). Logistic regression analysis revealed that atomic bomb survivorship was related to defective hMSH2 and/or hMLH1 expression. CONCLUSIONS: The prognosis of early gastric cancer in atomic bomb survivors was poor and was related to age and sex, rather than to being an atomic bomb survivor. Furthermore, a higher rate of defective hMSH2 and/or hMLH1 expression was observed in the survivors.

Surgery after preoperative chemotherapy for patients with unresectable advanced gastric cancer.

OBJECTIVE: The study aimed to evaluate the efficacy of surgery after preoperative chemotherapy for unresectable advanced gastric cancer. METHOD: Twenty patients with disappeared peritoneal dissemination or decreased lymph node metastasis by systemic chemotherapy underwent surgery (group S), while 14 with peritoneal dissemination or lymph nodes >N2 (group C) received continuous systemic chemotherapy. Among group S patients, 15 underwent a curative resection (group R0), while the other 5 did not microscopically undergo a curative resection (group R1). RESULTS: The median survival time for all patients was 535 days. Survival time was significantly dependent on the chemotherapy response (p < 0.002). The survival period in group S was significantly longer than that in group C (median survival time 747 vs. 476 days; p < 0.02). The relapse-free survival was 299 days in group S. In particular, the survival period of patients who underwent R0 surgery by preoperative chemotherapy was significantly longer than that of group R1 patients (median survival time 794 vs. 485 days; p < 0.02). Multivariate analysis revealed that R0 surgery was a significant and independent prognostic factor. CONCLUSION: Surgery was effective for advanced gastric cancer patients when performed as R0 resection following the disappearance of non-curative factors by preoperative chemotherapy.

Surgical outcomes of pancreaticoduodenectomy for periampullary tumors in elderly patients.

BACKGROUNDS: Pancreaticoduodenectomy (PD) is an aggressive surgery with considerable operative risks, but offers the only chance for cure in patients with periampullary tumors. A growing number of elderly patients are being offered PD because of the aging of populations in developed countries. We examined surgical outcomes of PD in patients aged 75 years and older (≥75 years). METHODS: A retrospective cohort study was performed in 65 consecutive patients who underwent PD for periampullary tumors at a single medical center during the 5 years from 2006 to 2010. We analyzed surgical outcomes such as mortality and morbidity after PD in patients aged ≥75 years (n = 21) compared to those in patients aged <75 years (n = 44). RESULTS: The positive rate of comorbidities such as hypertension was significantly higher in patients aged ≥75 years than in patients aged <75 years (76 vs. 48 %; p = 0.03). The incidence of wound infection was significantly higher in patients aged ≥75 years than in patients aged <75 years (19 vs. 0 %; p < 0.01). However, there was no significant difference in the mortality rate (0 vs. 2 %; p = 0.49) or the overall morbidity rate (33 vs. 32 %; p = 0.90). There was no significant difference in changes in body weight or serum albumin levels during the 3 months after PD between the two groups, but the recovery of serum prealbumin levels from 1 to 3 months after PD in patients aged ≥75 years was significantly delayed compared to that in patients aged <75 years (p = 0.04). There was no statistically significant difference in long-term survival between the two groups. CONCLUSIONS: Advanced age alone should not discourage surgeons from offering PD, although nutritional supports after PD for elderly patients aged ≥75 years are needed.

The clinicopathological impact of gross classification on solitary small hepatocellular carcinoma.

BACKGROUND/AIMS: The aim of this retrospective study was to determine the effect of gross classification on the outcome of hepatic resection for small solitary hepatocellular carcinoma (HCC). METHODOLOGY: This study consisted of 179 consecutive primary HCC patients who were not preoperatively diagnosed with vascular invasion or intrahepatic metastasis. The clinicopathological impact of gross classification was compared. Patients were classified into four groups, vaguely nodular (VN) type, single nodular (SN) type, single nodular type with extranodular growth (SNEG), and confluent multinodular (CMN) type, according to the gross classification of resected specimens. RESULTS: The SNEG and CMN types showed a significantly higher rate of MVI and intrahepatic metastasis than VN and SN type. Multivariate analysis showed SNEG and CMN type is independent predictor of MVI. The survival rates and the disease free survival rates of four groups were equal after curative hepatectomy. CONCLUSIONS: This study demonstrated that the gross classifications were correlated significantly with the prevalence of MVI or intrahepatic metastasis, and that aggressive tumor spread in the SNEG type and in the CMN type was observed even in patients with small solitary HCC.

Second hepatectomy for recurrent hepatocellular carcinoma achieved sustained virological response to interferon therapy for hepatitis C.

BACKGROUND/AIMS: Interferon (IFN) improves the prognosis of HCV-related hepatocellular carcinoma (HCC) in patients. However, the effects of IFN therapy for second hepatectomy (Hx) for recurrent HCC have not been established. METHODOLOGY: Subjects included 96 patients who underwent a second Hx for recurrence of HCV-related HCC. Forty-four patients received IFN therapy past or postoperatively of the first Hx. Twenty of those patients attained a sustained viral response (SVR). The other 24 were non-responders (NR) and 52 patients who had not received IFN therapy (non-IFN) were classified as the NR/non-IFN group. RESULTS: Overall survival (SVR group vs. NR/non-IFN group: 5-yr, 91.7 vs. 51.0%; p = 0.012) and disease-free survival (SVR group vs. NR/non-IFN group: 3-yr, 64.7 vs. 25.9%; p = 0.006) rates were significantly different in both groups. By multivariate analysis, NR/non-IFN therapy, was the independent risk factor for overall survival (p = 0.025) and disease-free survival (p = 0.006) after second Hx. CONCLUSIONS: SVR achieved past or postoperatively of the first Hx of HCV-related HCC significantly inhibits recurrence and consequently improves patient survival after second Hx for recurrent HCC. Patients with SVR to IFN therapy would be good candidates for second Hx for recurrent HCC.

Repeat hepatectomy for intrahepatic recurrence of cholangiolocellular carcinoma.

A 68-year-old man underwent a partial resection of the liver and lymph node dissection for a tumor, 3.0 cm in diameter, in S4 of the liver under the diagnosis of cholangiocellular carcinoma (CCC). The histological diagnosis was cholangiolocellular carcinoma (CoCC) and lymphatic permeation and venous invasion were recognized. Seven months after surgery, CT demonstrated two recurrent nodules in S7 and S8 of the liver, then a partial resection of the liver was performed. The gross and pathological findings were the same as the previously resected tumor. Four months after the second operation, CT demonstrated dilated intrahepatic bile ducts and lymph node swelling of the hepatic hilum. The patient died of disease thirteen months after the first operation. On the basis of the clinical and pathological features of this case, we consider that CoCC clinically resembles CCC and prognosis may be unfavorable, although it has characteristic pathological findings. It is still controversial whether CoCC should be accepted as a separate entity. The significance of repeat hepatectomy for recurrence and adjuvant chemotherapy should be clarified to improve the prognosis of CoCC.

Case of early adenosquamous carcinoma of the stomach.

Adenosquamous carcinoma of the stomach is very rare; at present, there are only seven published reports. We report here an eighth case involving a 77-year-old Japanese man who was diagnosed with gastric cancer by upper endoscopy and computed tomography (CT). He underwent laparoscopic-assisted distal gastrectomy for early gastric cancer and the resected specimen was diagnosed as adenosquamous carcinoma limited to the submucosal layer. Only one lymph node metastasis was noted. Seven months later, liver metastasis (3 tumors, 15 mm maximum in diameter) was detected by abdominal CT. He was started on chemotherapy with S-1 and cisplatin (CDDP) and is alive 14 months after surgery. Almost all cases of adenosquamous carcinoma of the stomach are diagnosed in advanced stages and carry a very poor prognosis. Most patients with early adenosquamous carcinoma of the stomach survive for 2 or more years without recurrence, however our patient experienced recurrence 7 months after surgery. Therefore, future treatment for recurrent adenosquamous carcinoma of the stomach should be considered.

Plasma D-dimer level as a mortality predictor in patients with advanced or recurrent colorectal cancer.

OBJECTIVE: Plasma D-dimer levels are elevated in patients with a variety of solid tumors. Recently, it has been reported that the level before curative surgery is a prognostic factor for colorectal cancer (CRC). We investigated whether the plasma D-dimer level before systemic chemotherapies is a predictor for advanced or recurrent unresectable CRC. METHODS: This study included 42 patients treated with systemic chemotherapies for advanced or recurrent unresectable CRC. Variables including clinicopathological factors, plasma D-dimer levels and the modified Glasgow Prognostic Factor Score (mGPS) were evaluated. RESULTS: The plasma D-dimer level was closely related to the mGPS. Survival was shorter for patients with plasma D-dimer levels >5 µg/ml than for those with lower levels. Compared with an mGPS of 0 or 1, an mGPS of 2 was predictive of poor prognosis (p < 0.0001). Old age, advanced stage, plasma D-dimer level and mGPS were significantly associated with mortality, but plasma D-dimer level was the only independent risk factor in multivariate analysis, and was significant related to the clinical response to chemotherapy (p < 0.05). CONCLUSIONS: Survival was significantly shorter in patients with elevated plasma D-dimer levels having advanced or recurrent CRC. The plasma D-dimer level before systemic chemotherapies was an independent mortality predictor.

Subcuticular absorbable suture with subcutaneous drainage system prevents incisional SSI after hepatectomy for hepatocellular carcinoma.

BACKGROUND: The effectiveness of subcuticular absorbable suture with subcutaneous drainage to decrease the risk of postoperative incisional surgical site infection (SSI) in hepatocellular carcinoma (HCC) patients was evaluated. METHODS: A total of 149 patients with HCC who underwent hepatectomy (Hx) were retrospectively investigated. Patients were divided into two groups: the patients with subcuticular suture combined with subcutaneous drainage (the drainage group; 61 patients) and the patients with nylon suture without subcutaneous drainage (the nylon group; 88 patients). After the operations, the complication rate of postoperative incisional SSI was analyzed and compared between the two groups. RESULTS: In the drainage group the rate of incisional SSI was significantly lower compared to the nylon group: 14-3 % (p = 0.033), respectively. Patients with incisional SSI needed significantly longer postoperative hospital care than the patients without incisional SSI: 28 versus 15 days (p < 0.005). Multivariate analysis revealed that subcuticular absorbable suture with subcutaneous drainage significantly reduced the occurrence of incisional SSI (odds ratio; 0.15; p = 0.034). CONCLUSIONS: We have demonstrated that the subcuticular suture with subcutaneous drainage is effective in preventing incisional SSI in patients undergoing Hx for HCC.

Outcome of hepatectomy in hepatocellular carcinoma patients aged 80 years and older.

BACKGROUND/AIMS: The aim of this retrospective study was to determine the effect of age on the outcome of hepatic resection in octogenarian patients with hepatocellular carcinoma (HCC). METHODOLOGY: Data of 408 consecutive primary HCC patients who underwent curative hepatectomy were studied. The surgical results of the younger group (<80 years of age) and the elderly group (≥80 years of age) were compared. RESULTS: Preoperative parameters, such as comorbid conditions and liver function tests, of the younger group (n=385) were comparable with those of the elderly group (n=23). Surgical data and the prevalence of postoperative complications did not differ significantly between the two groups. The long-term prognosis of the elderly group patients was almost identical to that of the younger group patients. Overall 3-year survival rates for the elderly group and the younger group were 95.7% vs. 84.8%, respectively (p=0.56). Disease-free three-year survival rates for the elderly group and the younger group were 47.2% vs. 47.7%, respectively (p=0.65). CONCLUSIONS: Hepatectomy is a viable treatment alternative with satisfactory surgical outcome for HCC even in patients aged 80 years or older.

Gastric carcinoma with protein-losing gastroenteropathy: report of a case.

This report describes the successful treatment of a case of true gastric cancer presenting as protein-losing gastroenteropathy. A 58-year-old Japanese male presented gastric carcinoma. His serum albumin and total protein levels were 1.8 and 4.2 g/dl, respectively. He was diagnosed with gastric cancer with protein-losing gastroenteropathy based on (99m)Tc-human serum albumin scintigraphy. The patient underwent a total gastrectomy following neoadjuvant chemotherapy. There are 23 detailed case reports of gastric carcinoma with protein-losing gastroenteropathy. Most of these cases had large villous or cauliflower-like gastric tumors that were defined as papillary or well differentiated adenocarcinoma. Gastric cancer with protein-losing gastroenteropathy is extremely rare, but it can easily be diagnosed if the villous or cauliflower-like features are well defined.

Laparoscopy-assisted resection for Mesenteric Castleman's disease: Report of a case.

A 65-year-old female patient was diagnosed with breast cancer in 1995. An abdominal mass was detected by computed tomography and the patient was preoperatively diagnosed with a gastrointestinal stromal tumor. Laparoscopy-assisted surgical resection revealed a mesenteric Castleman's tumor of the hyaline vascular type. Mesenteric Castleman's disease is rare, and there have been only 42 cases reported in the English literature. We herein discuss the clinical findings of these cases.

The long-term outcome of atomic bomb survivors with gastric carcinoma.

OBJECTIVE: During the decade following the 1945 atomic bombing of Hiroshima, a high incidence of leukemia was observed among atomic bomb survivors. Subsequently, the incidence of other cancers gradually increased while that of leukemia decreased. We examined the long-term clinical outcome of gastric cancer and second primary cancer in atomic bomb survivors. METHODS: Results of surgical treatment of gastric cancer were reviewed in 231 atomic bomb survivors and 759 control patients between 1995 and 2006. RESULTS: Long-term prognosis of gastric cancer in atomic bomb survivors was significantly poorer than that in control patients (P < 0.05). In a multivariate analysis, age, depth of tumor invasion, lymph node metastases, and curability were found to be significant and independent prognostic factors for gastric cancer. The incidence of second primary cancer after gastric cancer was significantly higher in survivors than in control patients (P < 0.01), because the number of elderly patients in the survivors was higher. CONCLUSIONS: Gastric cancer in survivors had a significantly poorer prognosis. Although the frequency of second primary cancer after gastric cancer in survivors was higher than that in control patients, it did not influence the prognosis.

Prognostic re-evaluation of peritoneal lavage cytology in Japanese patients with gastric carcinoma.

BACKGROUND/AIMS: The aim of the present study was to re-evaluate CY(+) with gastric carcinoma in Japanese patients to identify the characteristics that might distinguish patients with a poor prognosis from those with an intermediate prognosis among CY(+) patients. METHODOLOGY: CY(+) was found in 56 of 566 patients (9.9%) who had undergone surgery for gastric carcinoma between January 2000 and December 2006. The 56 patients with CY(+) were classified into four groups: group A, P(-)CY(+) (n = 10); group B, P1CY (+) (n = 10); group C, P2,3CY(+) (n = 18); group D, other (n = 18). RESULTS: The 5-year survival of all patients with CY(+) was 12%. A multivariate analysis demonstrated serosal invasion, lymph node metastasis, and CY(+) to be independent prognostic factors. However, the 5-year survival in group A was 30%. The prognosis of group A patients was significantly better than that of patients in any other group (Groups B, C, D; p < 0.02). Sites of the recurrence in group A were located only in the peritoneum but the lymph nodes, etc. CONCLUSIONS: Gastric carcinoma with CY(+) has a poor prognosis because it is associated with non-curative factors, peritoneal dissemination, and liver or lymph nodes metastases. However, a small subpopulation of patients with P(-)CY(+) showed an intermediate prognosis.

Hepatocellular carcinoma infiltrated with non-Hodgkin's lymphoma: report of a case.

A 70-year-old woman diagnosed to have a hepatitis C virus (HCV) infection was referred to our hospital because of a solitary liver tumor. because of a solitary liver tumor. She underwent a partial hepatectomy, and the tumor was histologically diagnosed as a hepatocellular carcinoma (HCC). diagnosed as a hepatocellular carcinoma (HCC). In addition, a focal follicle consisting of atypical lymphoid cells was seen within the HCC. cells was seen within the HCC. Two months later, she was readmitted because of weakness and rapidly developing abdominal fullness. developing abdominal fullness. An abdominal computed tomography scan showed widespread tumors with ascites. with ascites. A cytological examination of the ascites showed large-sized atypical lymphoid cells. showed large-sized atypical lymphoid cells. An immunohistochemical stain confirmed that the atypical lymphoid cells within the HCC were positive for the CD 20 antigen. antigen. Taking these findings into account, the hepatic tumor was determined to be a HCC infiltrated with diffuse large B-cell lymphoma. diffuse large B-cell lymphoma. The coexistence of HCC and non-Hodgkin's lymphoma (NHL) is extremely rare. and non-Hodgkin's lymphoma (NHL) is extremely rare. We herein report a case of HCC infiltrated with NHL. We herein report a case of HCC infiltrated with NHL.