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Objective: We investigated the efficacy of an interferon regimen characterized by an early virological response in patients with chronic hepatitis C and evaluated whether the patients virological status during therapy would be useful for predicting a complete response. Methods: We treated 62 patients with chronic hepatitis C with 6 million units (MU) of human lymphoblastoid interferon daily for 4 wk. The serum HCV RNA was assayed at week 2 by the reverse transcription-polymerase chain reaction. HCV RNA-negative patients (group A) received 6 MU of interferon three times weekly for an additional 22 wk (total dose, 564 MU). HCV RNA-positive patients were randomly assigned to group B-1, which received the same regimen as group A, or to group B-2, which received 6 MU of interferon daily for 4 wk followed by 6 MU three times weekly for 18 wk (total dose, 660 MU). Results: Complete responses were achieved by 19 (63.3%) of 30 group A patients, compared with one (6.3%) of 16 group B-1 patients and none of 16 group B-2 patients. The virological response at week 2 and the pretreatment serum HCV RNA level were independent significant predictors of a complete response. Conclusion: Patients who were still HCV RNA-positive at week 2 were unlikely to achieve a complete response after interferon therapy. An increase in the total dose of interferon failed to yield further benefit in these patients. [ABSTRACT FROM AUTHOR]

An autopsy case of a primary hepatic leiomyosarcoma, a rare malignancy in the liver, in a 62 year old female is documented with immunohistochemical investigation. The tumor measured 24 x 20 x 18 cm in the left lobe with multiple intrahepatic and distant metastases. Microscopically, the tumor was accompanied by massive coagulative necrosis. Remaining viable tumor tissue was mainly composed of two different lesions, a well to moderately differentiated leiomyosarcoma and a poorly differentiated, anaplastic lesion. Focal myxoid change was also identified. Well to moderately differentiated tumor cells were positive for smooth muscle actin and vimentin immunohistochemically. Those two histologically different tumors had their own metastatic foci in the lungs and other organs. A brief review of the literature is presented. [ABSTRACT FROM AUTHOR]