medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2002, Number 1

<< Back Next >>

Cir Gen 2002; 24 (1)

Multiple foci inflammatory pseudotumor of the liver. Report on one patient

Dergal BE, Capurso GM, Garmilla EJ, Guzmán NL, Hernández VJA

Language: Spanish
References: 32
Page: 47-52
PDF size: 127.59 Kb.


ABSTRACT

Objective: To describe the case of a patient who presented an inflammatory pseudotumor of the liver.
Setting: Third level health care hospital.
Design: Description of one case.
Description of the case: Male patient, 35 years old, without antecedents of hepatic pathologies. He was admitted to the hospital with pain in the right hypochondrium and fever of 39oC of two weeks evolution. Hepatic ultrasound revealed filling defects compatible with right lobe abscesses; computed axial tomography (CAT) showed lesions suggestive of metastases. Laboratory tests were normal, CEA, AFP, and CA19-9 were negative, and no infectious alteration could be demonstrated. The patient was subjected to exploratory laparoscopy, which discarded the presence of intraabdominal tumors, biopsies of the hepatic lesions were performed and the histological diagnosis confirmed the inflammatory pseudotumor diagnosis. Based on this result, a symptomatic treatment with antibiotics and steroids was initiated. Symptoms remitted in one week and a new CAT taken 6 months later revealed no lesions.
Conclusions: The inflammatory pseudotumor of the liver is a rare disease, of uncertain etiology, and which represents a diagnostic challenge. Its clinical characteristics resemble infectious diseases, and the present laboratory and imagining techniques are unable to differentiate it from primary or metastatic neoplastic processes affecting the liver. Therefore, histological confirmation is required for its diagnosis. Its evolution is generally self-limiting, therefore, it is important to take it into account at the time of diagnosis to avoid unnecessary and ample surgical resections. We consider laparoscopy an alternative method to fine needle biopsy, since it allows to obtain enough histological material and an ample exploration to discard any other possible diagnoses.


REFERENCES

  1. Symmers D. Primary hemangiolymphoma of the haemal nodes: an unusual variety of malignant tumour. Arch Intern Med 1921; 28: 467-74. “Citado en” Biselli R, Ferlini C, Fattorossi A, Boldrini R, Bosman C. Inflammatory myofibroblastic tumor (inflammatory pseudotumor): DNA flow cytometric analysis of nine pediatric cases. Cancer 1996; 77: 778-84.

  2. Umiker WO, Iverson L. Postinflammatory “tumors” of the lung. Report of four cases simulating xanthoma, fibroma, or plasma cell tumor. J Thorac Surg 1954; 28: 55-63.

  3. Anthony PP, Telesinghe PU. Inflammatory pseudotumour of the liver. J Clin Pathol 1986; 29: 761-8.

  4. Wiernik PH, Rader M, Becker NH, Morris SF. Inflammatory pseudotumor of spleen. Cancer 1990; 66: 597-600.

  5. Dao AH, Hodges KB. Inflammatory pseudotumor of the pelvis: case report with review of recent developments. Am Surg 1998; 64: 1188-91.

  6. Mathiak G, Meyer-Pannwitt U, Mathiak M. Inflammatory pseudotumor of the liver-rare differential diagnosis of an unknows hepatic mass. Case report and review of the literature. Langenbecks Arch Chir 1996; 381: 309-17. “Citado por” Maze GL, Lee M, Schenker S. Inflammatory pseudotumor of the liver and pregnancy. Am J Gastroenterol 1999; 94: 529-30.

  7. Horiuchi R, Uchida T, Kojima T, Shikata T: Inflammatory pseudotumor of the liver: clinicopathological study and review of the literature. Cancer 1990; 65: 1583-90.

  8. Lupovitch A, Chen R, Mishra S: Inflammatory pseudotumor of the liver. Report of the fine needle aspiration cytologic findings in a case initially misdiagnosed as malignant. Acta Cytol 1989; 88: 259-62.

  9. Gollapudi P, Chejfec G, Zarling EJ. Spontaneous regression of hepatic pseudotumor. Am J Gastroenterol 1992; 87: 214-7.

  10. Jackson RB, Gatling RR: Inflammatory pseudotumor of the liver. Surgery 1991; 109(3 pt1): 329-32.

  11. Hertzer NR, Hawk WA, Hermann RE. Inflammatory lesions of the liver which simulate tumor: report of two cases in children. Surgery 1971; 69: 839-46.

  12. Yoon KH, Ha HK, Lee JS, Suh JH, Kim MH, Kim PM et al. Inflammatory pseudotumor of the liver in patients with recurrent pyogenic cholangitis: CT-histopathologic correlation. Radiology 1999; 211:373-9.

  13. Pokorny CS, Painter DM, Waugh RC, McCaughan GW, Gallagher ND, Tattersall MH. Inflammatory pseudotumor of the liver causing biliary obstruction. Treatment by biliary stenting with 5-year follow-up. J Clin Gastroenterol 1991; 13: 338-41.

  14. Zamir D, Jarchwsky J, Singer C, Abumoch S, Groisman G, Ammar M et al. Inflammatory pseudotumor of the liver- a rare entity and a diagnostic challenge. Am J Gastroenterol 1998; 93: 1538-40.

  15. Maze GL, Lee M, Schenker S. Inflammatory pseudomotor of the liver and pregnancy. Am J Gastroenterol 1999; 94: 529-30.

  16. Shek TWH, Ng IOL, Chan KW. Inflammatory pseudotumor of the liver: report of four cases and review of the literature. Am J Surg Pathol 1993; 17: 231-38.

  17. White JE, Chase CW, Kelley JE, Brock WB, Clark MO. Inflammatory pseudotumor of the liver associated with extrahepatic infection. South Med J 1997; 90: 23-9.

  18. Coffin CM, Watterson J, Priest JR, Dehner LP. Extrapulmonary inflammatory myofibrobastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol 1995; 19: 859-72.

  19. Fukuya T, Honda H, Matsumata T, Kawanami T, Shimoda Y, Muranaka T et al. Diagnosis of inflammatory pseudotumor of the liver: value of CT. Am J Roentgenol 1994; 163: 1087-91.

  20. Ogawa T, Yokoi H, Kawarada Y. A case of inflammatory pseudotumor of the liver causing elevated serum CA19-9 levels. Am J Gastroenterol 1998; 93: 2551-5.

  21. Li GH, Li JQ, Lin YZ. Inflammatory pseudotumor of the liver. J Surg Oncol 1989; 42: 244-8.

  22. Collina G, Baruzzi G, Eusebi V. Inflammatory pseudotumor of the liver: report of two cases. Tumori 1987; 73: 407-12.

  23. Broughan TA, Fischer WL, Tuthill RJ. Vascular invasion by hepatic inflammatory pseudotumor: a clinicopathologic study. Cancer 1993; 71: 2934-40.

  24. Chan JK. Inflammatory pseudotumor. A family of lesions of diverse nature and etiologies. Adv Anat Pathol 1996; 3: 156-71.

  25. Guzmán Navarro L, Dergal Badue E, Capurso García MA, Hernández Valencia JA, Garmilla Espinoza J. Leiomiomatosis intravenosa: informe de una paciente. Cir Gen 2000; 22: 236-41.

  26. Someren A. “Inflammatory pseudotumor” of liver with occlusive phlebitis: report of a case in a child and review of the literature. Am J Clin Pathol 1978; 69: 176-81.

  27. Chen KT. Inflammatory pseudotumor of the liver. Hum Pathol 1984; 15: 694-6.

  28. Meis JM, Enzinger FM. Inflammatory fibrosarcoma of the mesentery and retroperitoneum: a tumor closely simulating inflammatory pseudotumor. Am J Surg Pathol 1991; 15: 1146-56.

  29. Standiford SB, Sobel H, Dasmahapatra KS. Inflammatory pseudotumor of the liver. J Surg Oncol 1989; 40: 283-7.

  30. Nakanuma Y, Tsuneyama K, Masuda S, Tomioka T. Hepatic inflammatory pseudotumor associated with chronic cholangitis: report of three cases. Hum Pathol 1994; 25: 86-91.

  31. Arber DA, Kamel OW, van de Rijn M, Davis RE, Medeiros LJ, Jaffe ES et al. Frequent presence of the Epstein-Barr virus in inflammatory pseudotumor. Hum Pathol 1995; 26: 1093-8.

  32. Biselli R, Ferlini C, Fattorossi A, Boldrini R, Bosman C. Inflammatory myofibroblastic tumor (inflammatory pseudotumor): DNA flow cytometric analysis of nine pediatric cases. Cancer 1996; 77: 778-84.




2020     |     www.medigraphic.com