肝脏反应性淋巴组织增生与慢性甲状腺炎并存：该病症的影像学特征

Reactive lymphoid hyperplasia of liver coexisting with chronic thyroiditis: radiographical characteristics of the disorder.

作者信息

Nagano K, Fukuda Y, Nakano I, Katano Y, Toyoda H, Nonami T, Nagasaka T, Hayakawa T

机构信息

Second Department of Internal Medicine, Nagoya University School of Medicine, Aichi, Japan.

出版信息

J Gastroenterol Hepatol. 1999 Feb;14(2):163-7. doi: 10.1046/j.1440-1746.1999.01817.x.

DOI:10.1046/j.1440-1746.1999.01817.x

PMID:10029298

Abstract

BACKGROUND

Reactive lymphoid hyperplasia of the liver is an extremely rare entity, with six cases reported so far.

METHODS

We encountered a 47-year-old Japanese female with reactive lymphoid hyperplasia of the liver, which coexisted with chronic thyroiditis. The lesion was discovered incidentally as a hypo-echoic mass with a hyper-echoic rim at a routine ultrasonography examination. It increased from 12 to 17 mm diameter in 6 months. Radiological studies, such as contrast-enhanced computerized tomography (CT) and angiography demonstrated a hypervascular lesion.

RESULTS

It was consequently diagnosed as a neoplasm with malignant potentiality and she underwent partial hepatectomy. The lesion was composed of small mature lymphocytes which formed prominent lymphoid follicles with germinal centres, scattered plasma cells and stromal fibrosis. Immunohistochemical study revealed polyclonal origins of the involved lymphocytes. DNA analysis for the immunoglobulin heavy gene and the T cell receptor beta gene using Southern blot hybridization showed no monoclonality. The following features have characterized the images in past cases, as well as ours: hypo-echoic mass, occasionally with a rim, in ultrasonography and hypervascularity, shown by angiography and enhanced CT.

摘要

背景

肝脏反应性淋巴组织增生是一种极其罕见的病症，迄今为止仅报道过6例。

方法

我们遇到一名47岁的日本女性，患有肝脏反应性淋巴组织增生，且合并慢性甲状腺炎。该病变在常规超声检查时偶然发现，为一个低回声肿块，周边有高回声环。6个月内其直径从12毫米增大至17毫米。放射学检查，如增强计算机断层扫描（CT）和血管造影显示为高血管性病变。

结果

最终诊断为具有恶性潜能的肿瘤，她接受了部分肝切除术。病变由小的成熟淋巴细胞组成，形成带有生发中心的显著淋巴滤泡，散在的浆细胞和间质纤维化。免疫组织化学研究显示受累淋巴细胞为多克隆起源。使用Southern印迹杂交对免疫球蛋白重链基因和T细胞受体β基因进行DNA分析，未显示单克隆性。过去病例以及我们病例的影像具有以下特征：超声检查显示为低回声肿块，偶尔有边缘，血管造影和增强CT显示为高血管性。