Inflammatory Pseudotumor of the Liver Complicated by Lung Necrosis and Pleural Empyema: A Case Report (original) (raw)
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Inflammatory Pseudotumor of the Liver: A Rare Case of Recurrence Following Surgical Resection
Journal of Radiology Case Reports, 2014
Inflammatory pseudotumor (IPT) of the liver is a rare, benign lesion that may be mistaken for malignancy. IPTs are difficult to diagnose due to nonspecific clinical, laboratory and imaging features. We report the case of a 38year old Asian male who presented with fatigue, weight loss and hepatomegaly. He was found to have a large hepatic IPT and underwent surgical resection; approximately two and a half years later, he developed acute cholangitis secondary to IPT recurrence. We present the imaging features of hepatic IPT using ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). We also review the literature on the diagnosis and management of this disease. The unique features of this case include the IPT's recurrence following surgical resection, large size and multiple modalities presented. CASE REPORT A 38-year old Asian male, originally from Hong Kong, initially presented to his family doctor due to fatigue, abdominal distension and weight loss. On physical exam, he appeared slightly jaundiced and had marked hepatomegaly and bilateral ankle edema. His past medical history was significant for pulmonary tuberculosis as a child and testicular teratoma at age 19, successfully treated with surgery and radiation. Sonography revealed a complex mass, 16.7cm in maximal diameter occupying the right hepatic lobe (Fig. 1). No internal flow was observed on colour Doppler. These findings were concerning for malignancy and CT scan was recommended.
Inflammatory pseudotumor of the liver
APMIS, 1990
The radiologic and histologic features of an inflammatory pseudotumor of the liver in a 62-year-old man are presented. The lesion was coincidentally discovered during clinical work-up of an acute pancreatitis caused by choledocholithiasis. Malignancy was suspected in the light of the radiologic presentation. To our knowledge, only 23 cases of inflammatory pseudotumor of the liver have appeared in the international literature. Its etiology remains unknown, although reactive-inflammatory or infectious mechanisms have been suggested. The present case seemed to be associated with bile flow obstruction, as the mass partially regressed following cholecystectomy and Vaterian sphincterotomy. Therefore, a hypothetical obstructive pathogenetic mechanism is considered. We conclude that this tumor-like condition must be considered in the differential diagnosis of solid masses in the liver.
A New Case of Spontaneous Regression of Inflammatory Hepatic Pseudotumor
Case Reports in Medicine, 2011
Introduction. Inflammatory pseudo-tumors (IPT) of the liver are rare and difficult to diagnose, because mimicking malignant tumors. Aim. We report a case of IPT of the liver wich diagnosis was made on clinical, radiological and evolutif features. Observation. A 15-year-old man had a 4-month history of abdominal pain in the right upper quadrant with fever and cought. Two successives ultrasonographies revealed a hypoechoic lesion occuping the segment VIII with 8 cm of diametre. Physical examination was normal. Laboratory investigation showed normal blood counts, liver function test and tumoral markers. Another ultrasonography was interpretated as normal. Tomodensitometry had showon a 3-cm lesion wich enhanced later after contrast injection. A second tomodensitometry done one mounth later described a 2-cm sub capsular heaptic lesion. Discussion. On routine activiy, pre operative diagnosis of IPT of the liver is difficut, and rarely made with certitude because mimicking a malignant tumor. In our cae report here, the analysis of previous history, of clinical, biological and radiological presentation, had permittes us to pose the diagnosis of PTI of the liver and this despite the absence of histological confirmation by percutaneous biopsy.
European Journal of Gastroenterology & Hepatology, 2007
Inflammatory pseudotumor of the liver is a rare, benign lesion characterized by a well-circumscribed mass of chronic inflammatory cell infiltration and proliferating fibrous tissue. Its etiology remains unclear, although inflammatory processes have been proposed. It is often misdiagnosed as a malignant tumor, and the management has been traditionally surgical. We report the case of a 16-year-old boy who was referred from another hospital with a fever of > 388C with rigor and right upper quadrant pain which he had suffered from for 5 days. The ultrasonographic computed tomography and MRI findings were not diagnostic, and we performed a needle biopsy from the lesion that was consistent with inflammatory pseudotumor (of liver, mixed fibrous tissue and chronic inflammatory cell infiltration). The patient was treated with nonsteroidal anti-inflammatory drugs and had an uneventful clinical course. During follow-up, the lesion subsequently shrank to completely vanish 1 year later.
Hepatic Inflammatory Pseudotumor: Know It to Recognize It
Inflammatory pseudotumor of the liver (IPTL) is a rare benign lesion that can mimic hepatic malignant neoplasms. A 79-year-old woman, in follow-up care for a left breast cancer, was referred to our Ultrasound Diagnostic Centre for a hepatic mass of unknown nature, displayed on PET-CT, CT and Abdominal Ultrasonography (US). The patient presented with abdominal pain and low-grade fever, increased values of C-Reactive Protein (CRP) and gamma-glutamyl transpeptidase (γGT). Abdominal US confirmed the presence of a heterogeneous polycyclic mass 4.0 × 3.7 cm in size, sub-capsular, localized in the segment VI, isoechoic in arterial phase and hypoechoic in portal and late phase on contrast-enhanced ultrasound (CEUS). A liver biopsy revealed the presence of chronic inflammatory cells without evidence of malignancy. As the patient did not respond to medical therapy, she underwent hepatic segmentectomy and cholecystectomy. At histology, the specimen showed acute and chronic inflammation with xanthogranulomatous features.
Journal of Laboratory Physicians, 2019
CONTEXT: Inflammatory pseudotumor (IPT) of the liver is a rare, tumor-like lesion that is considered to be biologically benign but often mimics malignancy. AIMS: The aim of the study was construe clinicopathological features, imaging findings, differential diagnosis, management, and follow-up of IPT involving the liver. SETTINGS AND DESIGN: It is a retrospective study. SUBJECTS AND METHODS: Cases included were of IPT, diagnosed on histopathology, at our center from June 2009 to December 2016. Details studied were clinical presentation, imaging studies, laboratory investigations, pathological features, treatment, and follow-up of the cases and compared with reports in the literature. RESULTS: A total of cases of IPT included were 17. The age of the patients ranged from 21 to 62 years. Common presenting features were intermittent fever, upper abdominal pain, and weight loss. Radiological diagnosis varied from neoplastic (13) to infectious etiologies (4), with hepatocellular carcinoma ...
Inflammatory Pseudotumour of the Liver
ANZ Journal of Surgery, 1988
A case of inflammatory pseudotumour of the liver is described, the twelfth such case reported. Although these lesions are benign and self-limiting, they may encroach upon the biliary tree or portal vein and may be confused with hue hepatic neoplasia. In the presence of single or multiple hepatic deposits seen on radiologic examination, a history of fever (or other systemic symptoms) and a negative fine needle aspiration biopsy should raise the possibility of inflammatory pseudotumour and prompt formal biopsy to guide further treatment.