Open AccessHepatic reactive lymphoid hyperplasia in a patient with primary biliary cirrhosis
Author(s) -
Mitsuaki Ishida,
Takeshi Nakahara,
Yousuke Mochizuki,
Tomoyuki Tsujikawa,
Akira Andoh,
Yasuharu Saito,
Hiroshi Yamamoto,
Fumiyoshi Kojima,
Machiko Hotta,
Tohru Tani,
Yoshihide Fujiyama,
Hidetoshi Okabe
Publication year - 2010
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v2.i10.387
Subject(s) - medicine , primary biliary cirrhosis , lymphoid hyperplasia , pathology , cancer , cirrhosis , nodule (geology) , lesion , hyperplasia , gastroenterology , lymphoma , paleontology , biology
Reactive lymphoid hyperplasia (RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles. Hepatic RLH is known to be associated with gastrointestinal carcinoma and autoimmune diseases including primary biliary cirrhosis (PBC). We report a case of hepatic RLH in a patient with PBC and gastric cancer. A 68 year old Japanese woman with a 10 year history of liver enzyme abnormality was admitted. Laboratory testing revealed that her anti-mitochondrial antibody was markedly elevated. Five mo after the diagnosis of PBC, she was found to have gastric cancer. Abdominal computed tomography disclosed a liver nodule in S8, suggesting metastatic gastric carcinoma. Histopathologically, the resected liver lesion comprised of a nodular proliferation of small lymphocytes with lymphoid follicles. This is the first reported case of hepatic RLH in a patient with both PBC and gastric cancer. Pre-operative diagnosis of hepatic RLH by clinical imaging is extremely difficult. Therefore, a needle biopsy could be useful to make a diagnosis of hepatic RLH, especially to differentiate from metastatic gastrointestinal carcinoma.