Ketoconazole, an imidazole derivative, is a broad spectrum antifungal agent which has been used widely in the treatment of systemic or local fungal infections. Mild asymptomatic elevation of plasma transaminase activities occurs in approximately 6% to 17.5% of patients who have used ketoconazole. However, the incidence of symptomatic hepatic injury is low and overt hepatitis develops in about 5% of the patients. Nausea and vomiting are the most frequent side reactions. Histopathological features of the reported ketoconazole induced hepatotoxicity are massive or submassive hepatocellular necrosis involving the acinar zone 3, destroyed lobular architecture with bridging necrosis and inflammatory cell infiltration on portal tracts. However, hepatic septal fibrosis with liver cirrhosis has not been reported yet.We experienced a case of hepatic septal fibrosis that developed after 9 months of ketoconazole administration.(Korean J Hepatol 2000;6:241-245)

Focal nodular hyperplasia (FNH) is a rare benign hepatic tumor occurring predominantly in women of childbearing age. Generally oral contraceptive is not associated with FNH but might accentuate the vascular abnormalities which may cause the lesion to enlarge and, very rarely, to rupture. FNH is typically asymptomatic and seldom bleeds. Often it is incidentally observed during imaging procedures performed for some other reasons. The histologic feature of FNH is characterized by areas of localized growth of mature hepatocytes and septal fibrosis. Surgical resection is seldom required because of the benign nature of the lesion and its lack of significant complication. We experienced a case of focal nodular hyperplasia without liver cirrhosis confirmed by surgical resection and histologic examination. in a 47-year-old man. (Korean J Hepatol 2000 ;6 :524 - 529)