Inflammatorische Pseudotumoren der Leber bei Morbus Crohn: ein möglicher Pitfall bei der Echokontrast-Sonografie

Abstract

Pseudotumours of the liver are rare entities, which cannot be differentiated from malignant liver lesions by contrast-enhanced ultrasound (CEUS) or radiological imaging. We report of a 22-year-old man with persistant abdominal pain and fever after appendectomy. Fundamental ultrasound showed an inflammatory swelling of the terminal ileum, suspicious of Crohn's disease as well as two solid liver lesions and left portal vein thrombosis. The enhancement patterns of both liver tumors on CEUS showed inhomogeneous isoenhancement during the arterial and portal phases and hypoenhancement during the late phase, mimiking malignant lesions. Ultrasound-guided biopsy, histology and follow-up, however, confirmed the diagnosis of hepatic inflammatory pseudotumour (IPT). When diagnosing a pseudotumour of the liver, the rare coincidence with chronic inflammatory bowel disease should be considered.