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Inflammatory pseudotumor of the liver in a patient with chronic hepatitis C: Difficulty in differentiating it from hepatocellular carcinoma
Author(s) -
Kim Soo Ryang,
Hayashi Yoshitake,
Kudo Masatoshi,
Matsuoka Toshiyuki,
Imoto Susumu,
Sasaki Kazunori,
Shintani Shigeyuki,
Song Kyung Boo,
Park Sok Yong,
Kim Jung Hyo,
Ando Kenji,
Koterazawa Toshihiro,
Kim Ke Ih,
Ninomiya Toshiaki
Publication year - 1999
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1046/j.1440-1827.1999.00927.x
Subject(s) - hepatocellular carcinoma , pathology , chronic hepatitis , medicine , inflammatory pseudotumor , hepatitis , immunology , lesion , virus
A case of an inflammatory pseudotumor of the liver in a 75‐year‐old female with chronic hepatitis C whose radiologic features simulated that of hepatocellular carcinoma (HCC) is presented. On imaging studies, hypervascularity by CO 2 ultrasound (US) angiography, enhancement at an early phase and isodensity at a late phase by incremental dynamic computed tomography (CT), perfusion defect by CT during arteriography (CTAP), and clinical background of hepatitis C virus (HCV) infection strongly suggested HCC. A US‐guided needle biopsy revealed a mainly diffuse and polyclonal proliferation of lymphocytes positive for leukocyte common antigen (pan‐lymphocyte cells), L‐26 (B cell lymphocytes), and UCHL‐1 (T cell lymphocytes), negative for both κ and λ light chains and sparsely distributed neutrophils and histiocytes. No lymphoid follicles were observed. The liver tissue around this tumor showed chronic hepatitis with mild activity and mild fibrosis. These histopathologic findings suggested that the diagnosis of inflammatory pseudotumor of the liver was tenable. As it is difficult to differentiate between inflammatory pseudotumor of the liver and HCC by imaging studies alone, supplemental biopsy, where possible, should be obtained when diagnostic imaging of tumors suggesting HCC is carried out. We emphasize that histopathology is a true gold standard in the diagnosis of this disease.