ABSTRACT
Focal inflammatory lesions are benign lesions of various etiology reported in numerous anatomic sites. Because of the development of imaging study, most of focal inflammatory lesions were noted incidentally without symptom and sign. Among them, eosinophilic liver disease and inflammatory pseudotumor are relatively important diseases and are associated with a variety of other disease such as parasitic infestations, bacterial and viral infection, allergic conditions, autoimmune disease, and internal malignancies. These are largely self-limiting entities and have favorable prognosis. The terminology of eosinophilic liver disease is not strictly defined and a variety of terms, including focal eosinophilic infiltration, eosinophilic abscess, and eosinophilic granuloma exist histologically. Inflammatory pseudotumor was composed of diffuse infiltration of spindle-shaped cells, myofibroblasts, and mixed inflammatory cells (plasma cells, lymphocytes, and histiocytes), microscopically. Focal inflammatory lesions are difficult to differentiate clinically from malignant tumors, because these show variable imaging findings. Thus, it is important to preoperatively distinguish these lesions from malignancy. Meticulous liver biopsy is frequently needed to make differential diagnosis from malignant tumors and to avoid unnecessary resection.
Subject(s)
Abscess , Autoimmune Diseases , Biopsy , Diagnosis, Differential , Eosinophilic Granuloma , Eosinophils , Granuloma, Plasma Cell , Liver , Liver Diseases , Lymphocytes , Myofibroblasts , PrognosisABSTRACT
The authors present a rare case of inflammatory pseudotumor of the liver whose differential diagnosis with hepatocellular carcinoma - in some cases - is only possible with the histological examination. In this case, a female patient, 38 years-old was suffering from abdominal pain, enlarged liver, thinning, tiredness and fever; alpha-fetoprotein, the liver function tests, amylase and lipase were normal. Abdominal ultrasound and computed tomography showed a node in the right liver lobe. The patient was submitted to a right hepatectomy for hepatocellular carcinoma. Histological examination showed an inflammatory pseudotumor of the liver. The patient was discharged from the hospital on the seventh postoperative day; she is asymptomatic for three years.
ABSTRACT
Ten patients with 12 inflammatory pseudotumor of the liver (IPL) lesions were routinely examined by gray scale uhrasonography(B-US),color Doppler (CD)and pulscd Doppler(PD). All of them in B-US were hypoechoic pattern with inhomogeneity,and one of them displayed helo-like,margin, suggesting malignant tumor. However, the irregular shape with calabash-like was found in 10 IPL lesions by B-US, being different from liver cancer.The color blood flow and arterial spectrum were detected by CD and PD in the margin 3 of 9 IPL lesions,and the resistant index was less than 0.5 in 2 of 3 IPL with Doppler signals, 6 of them were suggested to lack of blood supply, the manifistations of Doppler were consistent with pathology of IPL. Therefore, 8 lesions were considered to be benign lesions by Doppler US and the accuracy for the diagnosis of IPL was 56%(5/9)by using Doppler combined with B-US.
ABSTRACT
Objective To evaluate the diagnostic and differential diagnotic values of DSA features for inflammatory pseudotumor of the liver(IPL). Methods An retrospectively comparative analysis of 12 hepatic inflammatory pseudotumors confirmed surgicopathologically from May 2002 to March 2007 with DSA features and correlative imaging data were carried out. Results 10 cases consisted of only 1 lesion and other 2 cases with multiple lesions were opacified initially at the late arterial phase,with prominent peripheral ring-like staining at portovenous and parenchymal phases and less dense opacification in the central region; furthermore heterogenous staining occurred in 5 cases. Conclusions DSA is probable the most appropriate method for the diagnosis and differential diagnosis of hepatic inflammatory pesudotumor.