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Focal Inflammatory Lesions of the Liver

간의 국소 염증성 병변

  • Lee, Hyun Woong (Department of Internal Medicine, Chung-Ang University College of Medicine)
  • 이현웅 (중앙대학교병원 소화기내과)
  • Published : 2013.03.01

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.

Keywords

References

  1. Lee WJ, Lim HK, Lim JH, Kim SH, Choi SH, Lee SJ. Foci of eosinophil-related necrosis in the liver: imaging findings and correlation with eosinophilia. AJR Am J Roentgenol 1999;172:1255-1261. https://doi.org/10.2214/ajr.172.5.10227499
  2. Yoo SY, Han JK, Kim YH, Kim TK, Choi BI, Han MC. Focal eosinophilic infiltration in the liver: radiologic findings and clinical course. Abdom Imaging 2003;28:326-332. https://doi.org/10.1007/s00261-002-0050-2
  3. Lim JH. Toxocariasis of the liver: visceral larva migrans. Abdom Imaging 2008;33:151-156. https://doi.org/10.1007/s00261-007-9325-y
  4. Lee SH, Shin WG. Eosinophilic liver abscess caused by toxocara canis. Korean J Gastroenterol 2011;58:226-228. https://doi.org/10.4166/kjg.2011.58.4.226
  5. Jin SY. Eosinophilic liver abscess. Korean J Hepatol 2005; 11:176-179.
  6. Foong A, Scholes JV, Gleich GJ, Kephart GM, Holt PR. Eosinophil-induced chronic active hepatitis in the idiopathic hypereosinophilic syndrome. Hepatology 1991;13:1090-1094. https://doi.org/10.1002/hep.1840130614
  7. Shanti CM, Lucas CE, Tyburski JG, Soulen RL, Lucas DR. Eosinophilic abscess and eosinophilic pseudotumor presenting as bile duct masses: a report of 2 cases. Surgery 2001;130:104-108. https://doi.org/10.1067/msy.2001.113285
  8. Kaplan KJ, Goodman ZD, Ishak KG. Eosinophilic granuloma of the liver: a characteristic lesion with relationship to visceral larva migrans. Am J Surg Pathol 2001;25:1316-1321. https://doi.org/10.1097/00000478-200110000-00014
  9. Hong SW, Cho MY, Park C. Expression of eosinophil chemotactic factors in stomach cancer. Yonsei Med J 1999; 40:131-136. https://doi.org/10.3349/ymj.1999.40.2.131
  10. Kang HR, Kwon HS, Song WJ, et al. Analysis of 54 cases of eosinophilic liver abscess-underlying diseases and clinical characteristics. Korean J Asthma Allergy Clin Immunol 2004;24:229-235.
  11. Jang HJ, Lee WJ, Lee SJ, Kim SH, Lim HK, Lim JH. Focal eosinophilic necrosis of the liver in patients with underlying gastric or colorectal cancer: CT differentiation from metastasis. Korean J Radiol 2002;3:240-244. https://doi.org/10.3348/kjr.2002.3.4.240
  12. Kim YK, Kim CS, Moon WS, Cho BH, Lee SY, Lee JM. MRI findings of focal eosinophilic liver diseases. AJR Am J Roentgenol 2005;184:1541-1548. https://doi.org/10.2214/ajr.184.5.01841541
  13. Kim WH, Kim SH, Kim YH, et al. Fluorine-18-FDG PET findings of focal eosinophilic liver disease: correlation with CT and/or MRI, laboratory, and pathologic findings. Abdom Imaging 2010;35:437-446. https://doi.org/10.1007/s00261-009-9513-z
  14. Kim YS, Park SJ, Kim HK, Park JM. A case of eosinophilic abscess mistaken for metastasis due to FDG uptake in PET-CT. Korean J Gastroenterol 2009;54:349-354. https://doi.org/10.4166/kjg.2009.54.6.349
  15. Pack GT, Baker HW. Total right hepatic lobectomy; report of a case. Ann Surg 1953;138:253-258. https://doi.org/10.1097/00000658-195308000-00012
  16. Jin SY. Inflammatory pseudotumor of the liver. Korean J Hepatol 2005;11:90-93.
  17. Sari A, Tunakan M, Ünsal B, et al. Inflammatory pseudotumor of the liver diagnosed by needle biopsy: report of three cases (one with neuroendocrine tumor of the rectum and lung). Turk J Gastroenterol 2010;21:308-312. https://doi.org/10.4318/tjg.2010.0107
  18. Dehner LP. Inflammatory myofibroblastic tumor: the continued definition of one type of so-called inflammatory pseudotumor. Am J Surg Pathol 2004;28:1652-1654. https://doi.org/10.1097/00000478-200412000-00016
  19. Park KS, Jang BK, Chung WJ, et al. Inflammatory pseudotumor of liver: a clinical review of 15 cases. Korean J Hepatol 2006;12:429-438.
  20. Lee SL, DuBois JJ. Hepatic inflammatory pseudotumor: case report, review of the literature, and a proposal for morphologic classification. Pediatr Surg Int 2001;17:555-559. https://doi.org/10.1007/s003830000518
  21. 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;69:176-181. https://doi.org/10.1093/ajcp/69.2.176
  22. Horiuchi R, Uchida T, Kojima T, Shikata T. Inflammatory pseudotumor of the liver: clinicopathologic study and review of the literature. Cancer 1990;65:1583-1590. https://doi.org/10.1002/1097-0142(19900401)65:7<1583::AID-CNCR2820650722>3.0.CO;2-L
  23. 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;33:259-262.
  24. Jeong JY, Sohn JH, Kim TY, et al. Hepatic inflammatory pseudotumor misinterpreted as hepatocellular carcinoma. Clin Mol Hepatol 2012;18:239-244. https://doi.org/10.3350/cmh.2012.18.2.239
  25. Zen Y, Harada K, Sasaki M, et al. IgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis? Am J Surg Pathol 2004;28:1193-1203. https://doi.org/10.1097/01.pas.0000136449.37936.6c
  26. Faraj W, Ajouz H, Mukherji D, Kealy G, Shamseddine A, Khalife M. Inflammatory pseudo-tumor of the liver: a rare pathological entity. World J Surg Oncol 2011;9:5. https://doi.org/10.1186/1477-7819-9-5
  27. Su LD, Atayde-Perez A, Sheldon S, Fletcher JA, Weiss SW. Inflammatory myofibroblastic tumor: cytogenetic evidence supporting clonal origin. Mod Pathol 1998;11:364-368.
  28. Fukuya T, Honda H, Matsumata T, et al. Diagnosis of inflammatory pseudotumor of the liver: value of CT. AJR Am J Roentgenol 1994;163:1087-1091. https://doi.org/10.2214/ajr.163.5.7976880
  29. Choi M. Focal inflmmatory lesions of the liver. Clin Mol Hepatol 2012;18(Suppl 1):S18-22.
  30. Chong A, Jeong SY, Min JJ. Inflammatory pseudotumours resembling multiple hepatic metastases and their complete regression, as revealed by 18F-FDG PET/CT. Eur J Nucl Med Mol Imaging 2009;36:1199-1200. https://doi.org/10.1007/s00259-009-1132-y
  31. Schwarz RE, Reynolds JC, Lotze MT. "Pseudo-pseudotumor" of the liver: adenocarcinoma presenting as an inflammatory pseudotumor. Dig Dis Sci 1994;39:2679-2684. https://doi.org/10.1007/BF02087709
  32. Han JK, Kim SH. Inflammatory pseudotumor of the liver. Korean J Hepatol 2006;12:579-582.
  33. Hussong JW, Brown M, Perkins SL, Dehner LP, Coffin CM. Comparison of DNA ploidy, histologic, and immunohistochemical findings with clinical outcome in inflammatory myofibroblastic tumors. Mod Pathol 1999;12:279-286.
  34. Kawaguchi T, Mochizuki K, Kizu T, et al. Inflammatory pseudotumor of the liver and spleen diagnosed by percutaneous needle biopsy. World J Gastroenterol 2012;18: 90-95. https://doi.org/10.3748/wjg.v18.i1.90
  35. Ntinas A, Kardassis D, Miliaras D, Tsinoglou K, Dimitriades A, Vrochides D. Inflammatory pseudotumor of the liver: a case report and review of the literature. J Med Case Rep 2011;5:196. https://doi.org/10.1186/1752-1947-5-196

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