Inflammatory Pseudotumor of the Liver. MR imaging Findings.

Ijuin, Hiroyasu; Ono, Naofumi; Koga, Kensi; Yoshida, Tomoyuki; Ohnishi, Hiroyuki; Miyazaki, Shinpei; Ogata, Hideaki; Kohakura, Makoto; Ogawa, Kohei; Yamawaki, Makoto; Kusaba, Taku; Tanikawa, Kyuichi

doi:10.2739/kurumemedj.44.305

Cited by 13 publications

(5 citation statements)

References 13 publications

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“…The tumor was enhanced on portal and venous phases, but not on the arterial phase by dynamic MRI. These findings were in agreement with previous studies (3,4). However, IPT of the liver may show variable patterns on CTscan and MRIfindings.…”

Section: Discussionsupporting

confidence: 93%

Inflammatory Pseudotumor of the Liver Complicated with Recurrent Gouty Arthritis.

et al. 2001

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A 70-year-old man was referred to our hospital on June 25, 1999 because of recurrent painful tonic spasms in the upper abdomenand lower extremities. The patient used to work as a carpenter and had been retired for several years. He also had worked as a coal miner for a brief period. An appendectomy was performed at the age of 20. He underwent parathyroidectomy because of hyperparathyroidism in 1993. An episode of gout occurred some years before admission. He had been given diagnoses of hyperuricemia, essential hypertension, and supraventricular arrhythmia someyears earlier, and had been treated elsewhere. The treatment had been discontinued for morethan half a year at presentation.On physical examination, a tophus-like nodule was palpated in the right auricle. The patient's liver, spleen, and lymph nodes were not palpated. There was slight tenderness in the epigastrium. Neurological examination was negative. The temperature was 35.7°C, the blood pressure was 154/90 mmHg,and the pulse was 84/min and irregular.AnECGrevealed supraventricular and ventricular premature contractions. An abdominal computed tomographic (CT) scan disclosed a small simple cyst in the left lateral lobe of the liver (Fig. 1A). Upper gastrointestinal endoscopic and total colonoscopic examinations were performed because of positive tests for occult blood of feces. The patient had mild gastritis and colonic adenomatouspolyps. Cranial CT scan disclosed two lacunar infarctions in the bilateral basal ganglia. Since electroencephalogram disclosed abnormalspikes, sodium valpronate was begun under a tentative diagnosis of symptomatic epilepsy with modest improvement of the tonic spasms. Laboratory data on admission disclosed abnormal liver function tests (aspartate aminotransferase 121 IU//, alanine aminotransferase 68 IU//, and alkaline phosphatase 364 IU//), that returned spontaneously to the normal levels. Since the serum uric acid level was high (9.3 mg/dl), benzbromarone was prescribed. The serum uric acid level rapidly returned to the nor- antibiotics developed in a 70-year-old man suffering from intractable recurrent gouty arthritis. 67Ga-scintigraphy disclosed intense focal uptake in the upper abdomen. The lesion in the left lobe of the liver was an ill-defined hypodensity mass on computedtomographic scan and wasenhanced on dynamicmagnetic resonance imaging. The tumor was surgically removed and a diagnosis of IPT was made. Fever and arthritis resolved completely after surgery. Possible interaction between IPT of the liver and gouty arthritis was suggested. (Internal Medicine 40: 493-498, 2001)

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Section: Discussionsupporting

confidence: 93%

Inflammatory Pseudotumor of the Liver Complicated with Recurrent Gouty Arthritis.

et al. 2001

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“…HHN can be classified into benign and malignant in etiologies, including ICC, HM, HG, IPT, SNN, etc. 1 – 4 , 9 , 10 , 16 – 20 . Malignant nodules usually appear with advanced age, immune liver disease, history of malignancy, etc.…”

Section: Discussionmentioning

confidence: 99%

“…In earlier studies, characteristics of large lesions (>3 cm) and multiple lesions were reported 4 , 10 – 14 . However, to the best of our knowledge, the MRI features of small solitary hypovascular hepatic nodules (HHN) (≤3 cm) have not been reported so far.…”

Section: Introductionmentioning

confidence: 97%

MRI characteristics for the differential diagnosis of benign and malignant small solitary hypovascular hepatic nodules

Qian

Li²,

Ji³

et al. 2016

European Journal of Gastroenterology &Amp; Hepatology

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PurposeTo compare the MRI findings of benign and malignant solitary hypovascular hepatic nodules and identify the differentiating features.Materials and methodsA total of 135 patients with solitary hypovascular hepatic lesions up to 3 cm (mass forming intrahepatic cholangiocarcinoma, n=29; metastases, n=26; inflammatory pseudotumors and solitary necrotic nodule, n=48; and hemangioma, n=32) were assessed. MRI findings were analyzed, and lesions were scored for peripheral and intratumoral appearance and enhancement patterns.ResultsUnivariate and multivariate analyses showed that the most common findings for benign lesions were subcapsular, sharp margin, homogeneous, marked high signal on T2WI, mild hyperintensity on T2WI, increasing intensity of peripheral globular enhancement, and persistent central septum-like linear enhancement on delayed phase (P<0.05). An area under the curve of 0.955 was obtained for differentiating malignant from benign nodules using the combined imaging features of ill-defined margins, heterogeneity, decreasing intensity of peripheral rim-like enhancement, and central increasing intensity of patchy enhancement. Interobserver agreement was good, ranging from 0.72 to 1.00.ConclusionMRI may be a useful noninvasive method for determining whether hypovascular hepatic nodules are malignant or benign.

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“…Inflammatory pseudotumor of the liver is a rare benign disease, occasionally discovered by US, CT and MRI [5][6][7][8][9] . The etiology has not yet been very clear, and may be related to infection and immunogical compromise.…”

Section: Correlation Of Pathology With Mr Imaging Findingsmentioning

confidence: 99%

“…Until 1998, less than 80 cases had been reported in the world [1,2] . The accuracy of the pre-surgical diagnosis was low [3,4] , and very few materials on the diagnosis using dynamic MRI were reported [5][6][7] . We collected thirteen cases of inflammatory pseudotumor of the liver were collected and proved by pathology with MRI studies.…”

Section: Introductionmentioning

confidence: 99%