Hepatic Pseudolymphoma Mimicking a Hypervascular Tumor: A Case Report

Hepatic reactive lymphoid hyperplasia-associated primary biliary cholangitis masquerading as a neoplastic liver lesion

“…Additionally, chronic liver diseases including PBC, chronic viral hepatitis infections and non-alcoholic steatohepatitis were also found in this reported population. Therefore, it has been speculated that a chronic inflammatory or immune dysregulation could be a contributing factor 1–4 6–8. Gastric, renal, ovarian and pancreatic cancers have also been implicated and an immune reaction to cancer antigens is theorised; however, this association could just reflect the increased use of radiological abdominal examinations in this patient population 6 7…”

“…Due to these similar radiological findings, hepatic RLH was often misdiagnosed preoperatively as a malignancy 2 4 8. Surgical resection is usually undertaken, and needle biopsies were rarely performed mainly due to the potential risk of peritoneal dissemination 4.…”

“…In patients with PBC who have low-risk features, such as a small solitary liver lesion, young age, female gender, negative tumour markers, in the absence of cirrhosis on the basis of serum fibrosis score and/or liver elastography or early Scheuer stage (if biopsy performed of the ‘normal’ liver), the diagnosis of hepatic RLH should be considered 1–8 22 23. Lesional biopsy may be considered in preference to surgical resection to confirm a diagnosis.…”