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<p>Hepatocellular carcinoma (HCC) rarely develops in patients with Crohn’s disease (CD) without cirrhosis. Focal hepatic glycogenosis (FHG), characterized by localized hepatocellular glycogen accumulation, has been proposed as a potential preneoplastic lesion, particularly in the setting of long-term azathioprine (AZA) therapy. We report two non-cirrhotic CD patients who developed HCC during prolonged AZA treatment; both exhibited FHG in their background livers. A review of the literature identified only 13 previously reported HCC cases in CD patients, most of which were associated with AZA use or FHG. These findings suggest a possible link between CD, AZA therapy, FHG, and hepatocarcinogenesis. Long-term AZA therapy in CD may be involved in the development of FHG and may contribute to HCC development, even in non-cirrhotic livers, underscoring the need for careful liver surveillance in CD patients receiving prolonged AZA treatment.</p>

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Non-cirrhotic hepatocellular carcinoma during Crohn’s disease therapy with azathioprine : possible involvement of focal hepatocyte glycogenosis in hepatocarcinogenesis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月29日

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  • Hiroto Fujii,
  • Koji Sawada,
  • Nobuhiro Ueno,
  • Katsuyoshi Ando,
  • Kyozo Izumi,
  • Hidemi Hayashi,
  • Yu Ota,
  • Manami Hayashi,
  • Hideki Yokoo,
  • Mikihiro Fujiyaï

摘要

Hepatocellular carcinoma (HCC) rarely develops in patients with Crohn’s disease (CD) without cirrhosis. Focal hepatic glycogenosis (FHG), characterized by localized hepatocellular glycogen accumulation, has been proposed as a potential preneoplastic lesion, particularly in the setting of long-term azathioprine (AZA) therapy. We report two non-cirrhotic CD patients who developed HCC during prolonged AZA treatment; both exhibited FHG in their background livers. A review of the literature identified only 13 previously reported HCC cases in CD patients, most of which were associated with AZA use or FHG. These findings suggest a possible link between CD, AZA therapy, FHG, and hepatocarcinogenesis. Long-term AZA therapy in CD may be involved in the development of FHG and may contribute to HCC development, even in non-cirrhotic livers, underscoring the need for careful liver surveillance in CD patients receiving prolonged AZA treatment.