Inflammatory pseudotumor of the liver

Abstract

The radiologic and histologic features of an inflammatory pseudotumor of the liver in a 62‐year‐old man are presented. The lesion was coincidentally discovered during clinical work‐up of an acute pancreatitis caused by choledocholithiasis. Malignancy was suspected in the light of the radiologic presentation. To our knowledge, only 23 cases of inflammatory pseudotumor of the liver have appeared in the international literature. Its etiology remains unknown, although reactive‐inflammatory or infectious mechanisms have been suggested. The present case seemed to be associated with bile flow obstruction, as the mass partially regressed following cholecystectomy and Vaterian sphincterotomy. Therefore, a hypothetical obstructive pathogenetic mechanism is considered. We conclude that this tumor‐like condition must be considered in the differential diagnosis of solid masses in the liver.

Primary Hepatic Lymphoma Complicated by a Hepatic Inflammatory Pseudotumor and Tumor-Forming Pancreatitis

“…In our case, the hepatic IPT was initially circular with low attenuation, consistent with the major histological features of lymphoplasmacytic proliferation. We subsequently observed a spontaneous regression of the hepatic ITP, similar to several reported cases [3,6]. Lopez et al hypothesized that a hepatic ITP is an exuberant hepatic reaction to bile stasis because the reestablishment of bile flow seems to be a definitive event in its regression.…”

“…Lopez et al hypothesized that a hepatic ITP is an exuberant hepatic reaction to bile stasis because the reestablishment of bile flow seems to be a definitive event in its regression. Although the etiology of an IPT remains unclear, an important mechanism is that it can develop as a complication of cholangitis [2][3][4][5][6]. In the present case, the recurrent IPT appeared as an unusual tumor formation along the intrahepatic bile ducts, probably due to the development of intrahepatic cholangitis with biliary stasis or regurgitation after a choledochojejunostomy.…”

“…A hepatic inflammatory p s e u d o t u m o r ( I P T ) i s histologically characterized by proliferating fibrous tissue and inflammatory cells, and is generally considered to be benign in its biological behavior [1][2][3][4][5][6]. However, it can clinically masquerade as a malignant growth such as a hepatocellular carcinoma or a metastatic tumor [2][3][4].…”

“…However, it can clinically masquerade as a malignant growth such as a hepatocellular carcinoma or a metastatic tumor [2][3][4]. In some cases, an aggressive course of hepatic IPT has been reported [2,5].…”

Anaplastic Lymphoma Kinase (ALK) Positive Inflammatory Pseudotumor of the Liver: Conservative Treatment and Long-Term Follow-Up

“…Although the tumor is benign, its etiology remains unknown. Infection and biliary obstruction could be contributory causes to this lesion [9,13,19] . Studies from Japan reported several cases of the disease in association with autoimmune diseases of the pancreatobiliary system such as autoimmune sclerosing pancreatitis and primary sclerosing cholangitis [17,20] .…”