Endoscopic resection of large colorectal polyps using a clipping method

PURPOSE

In conventional endoscopic snare polypectomy, bleeding and perforation are the principal concerns. To prevent these complications, we employ an endoscopic clipping technique using the HX-3L clipping apparatus.

METHODS

With this method, clips are used to clamp the base of a polyp. A snare is hung peripheral to the clips. The polyp is then resected by coagulating and cutting with an electric current.

RESULTS

Neither bleeding nor perforation during or after polypectomy has occurred, nor have complications related to the use of clips developed. Gigantic polyps were not resected piecemeal, but rather were resected en bloc facilitating a clear determination of cancer on the surface of the resected site. Endoscopic clipping permitted site marking for colonoscopic surveillance.

CONCLUSION

We conclude that the clipping method has many advantages and is a useful technique in colonoscopic polypectomy.

Characteristic properties of retinal oxidase (retinoic acid synthase) from rabbit hepatocytes

Retinal oxidase (retinoic acid synthase) (EC 1.2.3.11) was purified electrophoretically, as a single protein band, from rabbit liver cytosol. The characteristic properties, enzymatic reaction mechanism, substrate specificity and kinetic parameters for retinals and molecular oxygen of the retinal oxidase were investigated. The Km values for all-trans-retinal of the retinal oxidase was the lowest than those for the other retinal derivatives. The retinal oxidase is a metalloflavoenzyme containing 2 FADs as the coenzyme, and 8 irons, 2 molybdenums, 2 disulfide bonds and 8 inorganic sulfurs. Its relative molecular mass was determined to be 270 kDa by gel filtration HPLC on a TSKgel G3000swXL column. Its minimum molecular mass was estimated to be 135 kDa by SDS-PAGE. The optical spectrum of the retinal oxidase showed absorption peaks at 275, 340 and 450 nm, and shoulders at 420 and 473 nm, in the oxidized form. The molecular extinction coefficients of the oxidase at selected wavelengths were determined. Circular dichroism spectra of the retinal oxidase were measured in the ultraviolet and visible regions. These spectra showed positive absorption in the visible region. The amino-acid composition was determined. The activity of the oxidase was not affected by any cofactors, such as NADP+, NAD+, NADPH and NADH, and it did not occur under anaerobic conditions. The oxidase was not inhibited by BOF-4272, a potent inhibitor of xanthine dehydrogenase, or rat anti-xanthine dehydrogenase IgG. Experiments on retinoic acid formation under 18O2 or H2(18)O demonstrated that the oxygen of water was incorporated into retinoic acid by the retinal oxidase, but not molecular oxygen.

Site distribution of colonic adenomas and carcinomas in relation to colonic flexures

To minimize the chance of overlooking colonic tumours, 'short segments' of the colon were defined and examined on barium enema films in relation to the distribution of colonic tumours. Films of 299 histologically proven adenomas and carcinomas from 265 consecutive patients were used. No significant differences in distribution were noted between the adenomas and carcinomas. The distance of tumours from distal minor flexures was within seven centimetres in 80% of lesions in the transverse colon, five centimetres in 80% of lesions in the descending colon, and four and six centimetres respectively for 80 and 95% of sigmoid colon lesions. In the cecum plus ascending colon 75% of the lesions were located within seven centimetres from the cecal pole.

Attenuating effect of antithrombin III on the fibrinolytic activation and microvascular derangement in rat gastric mucosa

The roles for the fibrinolytic activation and disorder of coagulation in formation of gastric ulcer induced by microvascular derangement were investigated. The rat stomach was exposed and repeated electrical stimuli (RES) were applied on the small arterial wall close to the lesser curvature to induce mucosal microcirculatory disturbances. The level of tissue-type plasminogen activator (t-PA), a key enzyme for fibrinolytic activity, in the regional blood of the stomach was significantly elevated immediately after RES. At 5 min after RES, the leakage of FITC-labeled albumin and thrombus formation in the mucosal microvasculature were visually demonstrated by using an intravital microscopic system. At 30 min, hemorrhagic erosions and linear ulcers were observed in the gastric mucosa. Pretreatment with human antithrombin-III (AT-III) in the range of 0.1-10 U/kg dose-dependently attenuated both the fibrinolytic activation and microvascular alteration promoted by RES. Human AT-III also prevented RES-induced gastric mucosal injury. Thrombin inhibitory activity in the gastric vein decreased (69.0 +/- 2.1%) just after RES, and further reduced at 30 min (47.7 +/- 5.3%). The present study suggests a hypothesis that human AT-III has a preventive effect on the gastric mucosal hemorrhagic changes via attenuating the fibrinolytic activation and subsequent microcirculatory disturbances.

Electron microscopic evidence of a viral nature for osteoclast inclusions in Paget's disease of bone

Circumstantial evidence from electron microscopic and immunological studies support the view that Paget's disease of bone represents a slow virus infection. However, there is only limited information available regarding its electron microscopic, enzyme and immunocytochemical characteristics. Two cases were studied using electron microscopy with particular emphasis on the inclusions in osteoclasts. Detailed ultrastructural and cytochemical studies including immuno-electron microscopy were performed. Some osteoclasts demonstrated specific virus-like structures composed of aggregations of microtubules in the nucleus and cytoplasm. The structures were easily digested by trypsin or protease, and were sensitive to RNase, which provided substantial evidence of a proteinaceous nature and inclusion of ribonucleic acid. Immunocytochemical examination identified binding of anti-respiratory syncytial virus and anti-measles virus antibodies in the tissue obtained from one of the two cases examined. The presence of viral antigens in structures in the cytoplasm of Pagetic osteoclasts supports the theory of paramyxovirus involvement in this disease.

Translocation (8;17)(p21;q21), a possible variant of t(15;17), in acute promyelocytic leukemia

We report a 64-year old man with typical features of acute promyelocytic leukemia (APL) [M3, French-American-British (FAB) classification] in whom a variant, t(8;17)(p21;q21), was detected. This is the second case of the same variant translocation to be reported. The breakpoint on 17q was similar to those described in cases with a standard translocation 15;17. Consequently, this chromosome break or rearrangement at band 17q21, rather than the recipient site of translocation of the deleted material, appears to be of crucial importance in the genesis of APL.

[Role of ammonia-monochloramine system in Helicobacter pylori--induced gastric mucosal injury]

Monochloramine is a reactive oxidant which is yielded by the reaction of neutrophil-derived hypochlorous acid and ammonia. Luminol-dependent chemiluminescence assay reveals that H. pylori directly elicits a respiratory burst of neutrophils. This activation is also observed by adding the bacterial supernatant of cultured or sonicated H. pylori, suggesting that H. pylori-derived soluble factor may be responsible for the release of chlorinated oxidants. In vitro cytotoxicity assay indicates that cultured rabbit gastric mucosal cells are significantly damaged by neutrophils which are stimulated by H. pylori. This injury is attenuated by urease inhibitor, antioxidants, and taurine (monochloramine scavenger). These data support the concept that ammonia-monochloramine system plays an important role in H. pylori-associated gastric mucosal injury. Omeprazole and rebamipide significantly inhibit not only H. pylori-induced respiratory burst of neutrophils but also H. pylori-associated urease activity. This evidence emphasizes the advantageous effect of these anti-ulcer compounds on H. pylori-positive gastric lesion and postulates a new strategy for anti-H. pylori treatment.

[Protective effect of a human immunoglobulin preparation on mouse experimental infection of methicillin resistant Staphylococcus aureus]

Methicillin resistant Staphylococcus aureus (MRSA) selectively increased by extensive chemotherapy is now one of the major causative agents of opportunistic infections in immunocompromised patients. Immunotherapy should be applied because this infection is based on the immunocompromised state of the patients. But this therapy has not been applied because S. aureus is known to have protein A which binds to the Fc portion of IgG and blocks phagocytosis through Fc receptor of phagocytic cells which plays the major role for the killing of infected bacteria in vivo. It should be known that MRSA strains often did not express protein A. Recently isolated MRSA strains were collected from three medical institutions and examined for their expression of protein A. Incidences of protein A-negative strains were different among institutions. It was found that more than a half of the strains from a general hospital which expressed typical heat sensitive methicillin resistance did not express protein A, but that incidences of protein A-negative strains were around 20% in the MRSA strains of a complicated history from a university hospital and a research center. All protein A-negative strains were found to be agglutinated by a commercially available immunoglobulin preparation (Venilon). And this immunoglobulin was proved to have a protective effect for the mouse experimental infections of these protein A-negative MRSA strains.

[A human monoclonal antibody cocktail for experimental mouse infection with clinically isolated strains of Pseudomonas aeruginosa]

A human IgG monoclonal antibody cocktail against Pseudomonas aeruginosa serotypes A, B, E, G, I, and M (MCA5) was tested for its therapeutic effect on the infected mice with clinically isolated P. aeruginosa strains. More than 80% of the collected strains were found to belong to the above six serotypes. Direct agglutination with MCA5 gave slight reduced rates, but over 70% of the strains were agglutinated with MCA5. Fifty percent lethal doses of the representative strains to mice (LD50) were estimated, and 50% protective doses of MCA5 to the infected mice with 5 LD50 of the strains (ED50) were determined. MCA5 was found not to be protective to all the infected mice with above six serotypes but protective only to the mice infected with the agglutinated strains. Confirmation of the agglutination of the causative organism with MCA5 is required for the treatment by MCA5. ED50 for a clinically isolated strain and the virulent stock strain were determined under the various challenge doses. It was found that ED50 increased in parallel with the increase of challenged doses but did not change depending on the virulence of the infected strains. These results indicated that this cocktail worked as opsonin. Opsogenic anti-O IgG antibody could be most effective to protect the opportunistic infections caused by the bacteria which have not so powerful exotoxins.

Mechanisms of endothelin-induced macromolecular leakage in microvascular beds of rat mesentery

Microvascular responses to endothelin-3 were investigated in the rat mesentery under fluorescence microscopy. Endothelin-3 in a range of 0.1-100 pM induced arteriolar constriction in a dose-dependent manner, and stimulated Ca2+ mobilization, demonstrated by fura-2-associated fluorography, in both arterioles and venules. Cyclo(-D-Trp-D-Asp-Pro-D-Val-Leu-) (BQ123), and endothelin ETA receptor antagonist, at a concentration of 10 microM inhibited the endothelin-3 (100 pM)-induced arteriolar constriction and Ca2+ mobilization in arterioles but not in venules. In venules, an early onset leakage of FITC (fluorescein isothiocyanate)-labeled albumin and subsequent reduction of red blood cell velocity without arteriolar constriction were observed after the superfusion of endothelin-3 with BQ123, suggesting that a non-endothelin ETA receptor mediates macromolecular leakage followed by a decrease in blood flow. Endothelin-3 with BQ123 neither stimulated leukocyte adhesion nor activated luminol-dependent chemiluminescence in venules, showing that endothelin-3-increased permeability may be induced by leukocyte-independent and oxyradical-independent mechanisms. These microvascular alterations of permeability and red blood cell velocity were significantly attenuated by the addition of phalloidin, an F-actin stabilizer, suggesting the involvement of endothelial cell contraction. Nicardipine (1,4-dihydro-2,6-dimethyl-4-[3-nitrophenyl]methyl-2- [methyl(phenylmethyl)amino]-3,5-pyridinedicarboxylic acid ethyl ester), a dihydropyridine-type Ca2+ channel antagonist, eliminated endothelin-3-induced arteriolar constriction; however, it did not affect albumin leakage promoted by endothelin-3 with BQ123, suggesting that a non-voltage-dependent Ca2+ channel(s) is involved in non-endothelin ETA receptor-mediated Ca2+ mobilization and contraction of venular endothelial cells. Overall, it is conceivable that endothelin ETA receptor and voltage-dependent Ca2+ channel are involved in endothelin-3-induced arteriolar constriction. In addition, the present results suggest that Ca2+ mobilization in venular endothelium, which is mediated by a non-endothelin ETA receptor, possibly endothelin ETB receptor and regulated by non-voltage-dependent Ca2+ channel(s), may cause endothelial cell contraction and subsequently increase macromolecular permeability in microvascular beds treated with endothelin-3.

Influence of fatty acid absorption on bidirectional release of immunoglobulin A into intestinal lumen and intestinal lymph in rats

Effects of absorption of long and middle chain fatty acids on IgA secretion into the intestinal lumen and intestinal lymph and the factors which evoke changes in IgA secretion during the absorptive process were examined in rat small intestine. Bidirectional secretion of IgA from the intestinal mucosa into the intestinal lumen and intestinal lymph was continuously observed in the control condition. Perfusion of oleic acid (a long-chain fatty acid) micelle into the jejunal loop induced a significant increase in IgA output into the intestinal lymph. In contrast, lymphatic output of IgA was significantly decreased when oleic acid micelle was administered intraduodenally. Absorption of octanoic acid, a middle-chain fatty acid, did not produce any significant changes in IgA output into either direction. CR1505, a CCK-receptor antagonist, significantly attenuated the oleic acid-induced increase in IgA secretion into the intestinal lumen, but did not affect the oleic acid-induced decrease in lymphatic IgA secretion. Pluronic L-81, an inhibitor of chylomicron formation and secretion, significantly attenuated the decrease in IgA output into the intestinal lymph during oleic acid absorption without affecting the luminal IgA output. The rate of release of IgA into the intestinal lumen is stimulated by absorption of long-chain fatty acids possibly through the influence of locally released CCK, while the transport process of IgA into lymphatics is controlled by a different mechanism which is closely correlated with the intracellular formation and secretion of chylomicron.

Crossover comparison between the depressor effects of low and high work-rate exercise in mild hypertension

1. The relationship between work-rate and the antihypertensive effect of exercise in hypertensives, and the mechanism of that effect, were investigated by a crossover clinical trial. 2. Ten mild hypertensives were randomly divided into two groups. One group performed low work-rate exercise (LWE) on a cycle ergometer for 10 weeks (blood lactate threshold; approximately 50% of maximum oxygen consumption [Vo2max]). After a 10 week interval without exercise training, these subjects were then switched to a high work-rate exercise (HWE) regimen (4 mmol/L of blood lactate; approximately 75% of Vo2max) for another 10 weeks. In the other group, the order of exercise training was reversed. Since two patients withdrew from the protocol during HWE periods, statistical analysis was performed on the data from the remaining eight patients. There were no order effects observed in any of the data from the two groups. 3. During both LWE and HWE, resting blood pressure (BP) fell significantly after the initiation of exercise therapy (P < 0.05). Furthermore, the overall effects of 10 weeks of LWE and HWE on BP were not significantly different. 4. The work-rate at the lactate threshold, which reflects physical fitness, had increased significantly by 16 W (P < 0.01) after the LWE period and by 11 W (P < 0.01) after the HWE. 5. During the LWE period, changes in haemodynamic and humoral variables were not significant, except for a reduction in plasma norepinephrine at week 10 (P < 0.05). In the HWE period, changes in haemodynamic and humoral variables were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunity to jellyfish venoms: suppression of venom-induced immune responses in ultraviolet B-irradiated mice

Lymph node and spleen cells from mice immunized with sea nettle (Chrysaora quinquecirrha) venom exhibited a proliferative response after exposure to the homologous antigen or that of a related jellyfish, Physalia (Portuguese man-o'-war). Native venom was a more effective stimulant than heated, non-lethal venom. Ultraviolet light treatments administered to the skin either before or after venom sensitization suppressed the proliferative response of these internal immune cells.

Increased expression of nucleoside diphosphate kinase/nm23 and c-Ha-ras mRNA is associated with spontaneous lung metastasis in rat-transplantable osteosarcomas

The relationship between expression of nucleoside diphosphate kinase (NDP kinase)/nm23, c-Ha-ras, and c-myc genes and metastatic potential was assessed in rat-transplantable osteosarcoma lines, derived from spontaneous and chemical carcinogen (4-hydroxyamino quinoline 1-oxide)-induced osteosarcomas in Fischer 344/NS1c rats. These osteosarcomas possess metastatic potential and highly metastatic lines spontaneous osteosarcoma-selected lung metastatic lesions and 4-hydroxyamino-quinoline 1-oxide-induced osteosarcoma-selected lung metastatic lesions were respectively established by selectively transplanting lung metastatic lesions. Northern blot analysis revealed that the levels of NDP kinase/nm23 and c-Ha-ras gene expression were increased in line with metastatic ability; thus transcript levels were remarkably greater in both spontaneous osteosarcoma-selected lung metastatic lesions and 4-hydroxyamino-quinoline 1-oxide-induced osteosarcoma-selected lung metastatic lesions highly metastatic lines than in their respective low metastatic spontaneous and chemical carcinogen (4-hydroxyamino quinoline 1-oxide)-induced osteosarcoma counterparts. c-myc mRNA expression was observed in all tumor lines, without any correlation with metastatic ability. Southern blot analysis did not show evidence of gross rearrangement or amplification of NDP kinase/nm23, c-Ha-ras, or c-myc genes suggesting regulation of their gene expression at the transcriptional and/or posttranscriptional level. These results indicate that NDP kinase/nm23 and c-Ha-ras might be cooperatively involved in a positive manner in signal transduction processes, especially involving G-protein reactions, responsible for metastasis of rat-transplantable osteosarcomas.

[Systemic adjuvant chemo-endocrine therapy after breast conservation treatment for breast cancer]

The majority of patients who have undergone breast conserving surgery proved to be node-negative. Node-negative breast cancer has a fairly good prognosis, achieving a 10 year disease-free survival rate of 88%. Patterns of recurrence and relapse in node-negative cases are characterized by a higher ratio of hematogenous metastases after relatively longer disease-free intervals. Such cases have been considered the best indications of systemic adjuvant therapy. Postoperative adjuvant trials using cyclophosphamide (CPA) and/or tamoxifen (TAM) were conducted at the Aichi Cancer Center Hospital, and the following results were obtained concerning adjuvant treatment for early-stage (node-negative or stage I) breast cancer; (1) In the post-menopausal group, CPA and/or TAM administration was recommended as the treatment of choice. (2) In the postmenopausal group, TAM was evaluated as the key drug. After TAM alone or TAM plus CPA administration, an improvement in the disease-free survival rate was expected. (3) After administration of CPA alone in the postmenopausal group, there were no demonstrable benefits. On the contrary, adverse effects were suspected. (4) The risk of contralateral breast cancer was reduced to two-thirds when TAM was administered as an adjuvant therapy.

[A case of interferon-alpha-induced pneumonitis]

We report a case of interferon-alpha-induced pneumonitis. A 61-year-old man was diagnosed as having recurrence of renal cell carcinoma and treated with 3 x 10(6) unit of interferon-alpha daily for 8 weeks. On the 55th injection, he presented with a high fever and mild dyspnea, and his chest CT films revealed diffuse reticulonodular shadows in both lung fields. We suspected interstitial pneumonitis due to interferon-alpha, and started steroid therapy. He showed rapid improvement of symptoms and diffusing capacity, and the pulmonary infiltrates in his chest CT were markedly reduced. Transbronchial lung biopsy (TBLB) revealed slightly thickened alveolar walls and small granulomatous-like lesions. These granulomatous-like lesions showed marked accumulation of macrophages. To our knowledge, this is the first report of interferon-alpha-induced pulmonary injury in Japan.

Post-synaptic potentiation of vagal contractile responses by neurokinin A

We have studied the effect of neurokinin A (NKA) on tracheal smooth muscle (TSM) contraction caused by administration of acetylcholine (ACh) intra-arterially (ia) into the tracheal circulation, or bilateral stimulation of the vagus nerves, in 26 mongrel dogs. The tracheal contractile response to 10(-7) mol NKA was 3.12 +/- 0.48 g/cm, 6.3 +/- 0.7%AChmax. Plasma histamine concentration was measured in the right atrium at the peak response following administration of NKA. Plasma histamine concentration was 3.33 +/- 2.05 ng/ml after 10(-7) mol NKA (vs. 1.82 +/- 0.54 ng/ml for control, P > 0.10). A frequency-response curve was generated by electrical stimulation of the caudal ends of cut cervical vagi over the range of frequencies 1-20 Hz (constant 30 V) at 15 s intervals 10 min before and 10 min after administration of 10(-8) mol NKA. Substantial augmentation of tracheal contractile responses to 10(-10)-10(-7) mol ia ACh was obtained 10 min after administration of NKA (P < 0.05). Significant potentiation of tracheal contraction to vagal stimulation for 10-20 Hz was also observed after administration of 10(-8) mol NKA (P < 0.05). We have demonstrated a substantial contractile effect of NKA on canine tracheal smooth muscle that is not related to histamine release from respiratory mast cells. We have also demonstrated that NKA causes augmentation of the parasympathetic tracheal contractile response induced by ia administration of ACh and efferent vagus nerve stimulation. These data suggest that potentiation of vagal contractile response by NKA is related to post-synaptic activation of the parasympathetic nerves.

Nitric oxide mediates lipopolysaccharide-induced alteration of mitochondrial function in cultured hepatocytes and isolated perfused liver

The influence of endogenous nitric oxide, which is generated by stimulation with lipopolysaccharide, on the mitochondrial energization of rat hepatocytes was investigated in vitro and ex vivo. Using a fluorescence microscope equipped with a silicon intensifier target camera, we visualized fluorescence of rhodamine-123, a mitochondrial energization-sensitive fluorescence probe, in individual hepatocytes and measured the fluorescence intensity with a digital imaging processor. Although addition of Kupffer cells or lipopolysaccharide in a range of 0.1 to 1.0 microgram/ml caused no significant alteration in the fluorescence in hepatocytes, Kupffer cells plus 1.0 microgram/ml lipopolysaccharide reduced fluorescence intensity in the cocultured hepatocytes. The alteration of rhodamine-123 fluorescence in the hepatocytes induced by lipopolysaccharide-activated Kupffer cells was significantly inhibited by the addition of NG-monomethyl-L-arginine, a selective inhibitor of nitric oxide synthesis. The transportal infusion of lipopolysaccharide also decreased rhodamine-123 fluorescence in perfused rat liver. The decrease was significantly enhanced in the pericentral regions. Autofluorescence of NADH was elicited by continuous infusion of lipopolysaccharide; this reaction was also enhanced in the pericentral regions. We showed the main site of uptake of infused lipopolysaccharide in the hepatic lobule to be in the periportal regions with fluorescein isothiocyanate-labeled lipopolysaccharide. Our results indicate that the inhibition of mitochondrial energization occurs mainly in pericentral regions, which are distant from the lipopolysaccharide uptake site. The continuous administration of NG-monomethyl-L-arginine significantly attenuated the lipopolysaccharide-induced decrease in rhodamine-123 fluorescence and increase of the NADH contents of the hepatic lobule.(ABSTRACT TRUNCATED AT 250 WORDS)

Modeling approach to eliminate the need to separate arterial plasma in oxygen-15 inhalation positron emission tomography

A mathematical model has been developed to predict the arterial metabolite concentration curve using the whole blood radioactivity curve in positron emission tomography (PET) during 15O2 inhalation. Production of arterial H2 15O due to aerobic metabolism in the body was modeled as a single rate constant, which was determined from 200 steady-state values of plasma and whole blood concentrations recorded during continuous inhalation of 15O2 and C15O2. Comparison of this method in eight 15O2 inhalation studies (four at rest and four during motor stimulation) performed on four subjects resulted in: (1) arterial H2 15O curves that were well matched in shape to those measured by the frequent plasma separation and (2) cerebral metabolic rate of oxygen (CMRO2) and cerebral blood flow (CBF) were consistent with those obtained by the frequent plasma separation procedure (maximum difference was 3%). An error sensitivity analysis was also performed and demonstrated that errors expected in this modeling approach caused only negligible errors in CMRO2 and CBF estimates. Thus, the arterial H2 15O concentration curve can be accurately predicted using the whole blood time-activity curve; hence, plasma separation can be avoided in 15O2 inhalation PET.

Regional differences in microvascular response in rat intestine during acute elevation of portal pressure

The effect of acute elevation of portal pressure on the blood flow of rat intestinal microvessels was studied using a laser Doppler velocimeter and in vivo microscopy. The total intestinal blood flow decreased when portal pressure increased more than +15 cmH2O above the basal value. Blood flow in villus capillaries did not change at portal pressures of +5 to +15 cmH2O, but did decrease at +20 cmH2O. Blood flow in muscle capillaries decreased at all steps of portal hypertension. Red blood cell velocity was decreased by portal hypertension in large venules, but not in small venules of the submucosa. Large venules, but not small venules, dilated in acute portal hypertension. Large arterioles in the submucosa constricted, while small arterioles dilated at portal pressures of +10 to +15 cmH2O. In conclusion, the intestinal microvascular flow response differs according to the degree of portal hypertension and the location on the microvascular tree. Blood flow in villus capillaries and in small submucosal venules is maintained at a small degree of portal hypertension.

Hepatic granuloma with progressive calcification: CT appearance

Calcification in the liver is uncommon but not rare in clinical practice, and may be caused by many pathological conditions. We report a patient with hepatic mass on abdominal sonogram and CT scan. The mass was shown as a hypoechoic lesion on abdominal sonogram and as a well-marginated hypodense mass on pre- and postcontrast CT. Inflammatory granuloma was diagnosed by pathological examination following percutaneous needle biopsy. A follow-up precontrast CT scan was performed 22 months after the initial examination, and the hepatic granuloma could be the cause of hepatic parenchymal calcification.