Multiple Inflammatory Pseudotumors of the Liver Associated with Acute Myeloblastic Leukemia

Abstract

A 26-year-old man, diagnosed with acute myelogenous leukemia had multiple inflammatory pseudotumors (IPT) in the liver. The patient presented complete remission after remission induction therapy, and then showed right upper quadrant discomfort and intermittentfever. An ultrasonography disclosed multiple hypoechoic nodules in the liver. A biopsy of the nodules showed focal liver cell necrosis with scant inflammatory cells, compatible with IPT. After several courses of chemotherapy, the nodules in the liver increased. The second liver biopsy of the nodule showed fibrosis. Multiple IPTs in the liver should be distinguished from abscess and metastatic nodules.

Inflammatory pseudotumor of the liver associated with malignant disease: report of two cases and a review of the literature

“…In cases 6 and 10, a cystic space was detected in the lesions of the liver, and Staphylococcus aureus was cultured from the cystic fluid in both cases. Obliterating phlebitis was found Ishida et al [7] Saito et al [13] Akiyama et al [1] Kobayashi et al [9] Yokoyama et al [9] Nakamura et al [9] Isobe et al [8] Tajima et al [16] Newbould et al [11] a Cancer stage is classified using TNM Classification of Malignant Tumors (Sixth Edition) from the International Union Against Cancer in case 3 [9] and our present cases (cases 1 and 2). Therefore, the etiology of hepatic IPT may be similar to that of the pyogenic liver abscess because of the similarity of associated cancer types and the etiological correlation of clinical course in some patients.…”

“…Some IPT of the liver have been associated with malignant tumors. In the English-language literature, 6 such cases have been reported [1,7,8,11,13,16] and 4 such cases in the Japanese-language literature [9]. The clinical findings of 10 reported cases and the present 2 cases are summarized in Table 1; 11 cases were reported from Japan and 1 from the United Kingdom.…”

“…In cancer patients, Japanese patients were predominant even in the English-language literature [1,7,8,13,16]. It has been reported that all hepatic IPT patients are predominantly Japanese: 17 of 51 patients (33%) are Japanese [15].…”

“…Some cases of IPT of the liver have been associated with malignant tumors [1, 7-9, 11, 13, 16]. Six such cases have been reported in the English-language literature [1,7,8,11,13,16] and four cases in Japanese-language literature [9], but the etiological correlation between hepatic IPT and liver abscess in cancer patients has never been mentioned. In this paper, we report two cases of IPT of the liver with gastrointestinal tract cancer and discuss the etiological correlation between IPT and abscess of the liver in cancer patients.…”

Przydatność badań tomografii komputerowej i rezonansu magnetycznego w ocenie zaawansowania i postępów leczenia chorób nowotworowych u dzieci.

“…These are quite rare lesions of unknown etiology, which do not exhibit features of mycosis in histopathological examination, only the features of necrosis and fibrosis [10]. …”