Fernández de la Puebla Giménez R A, García Alegría J, Lechuga Varona M T, Blanco Molina M A
Unidad de Medicina Interna, Hospital Costa del Sol, Marbella.
Gastroenterol Hepatol. 1999 Jan;22(1):14-7.
A new case of hepatic inflammatory pseudotumor (HIP) is reported. A 66-year-old woman presented with fever and toxic syndrome. Analysis demonstrated an elevation in erythrocyte sedimentation, CRP, leukocytosis and normocytic anemia. A lesion was observed on ultrasonography in the right hypoechoic hepatic lobe with echos within (mosaic pattern). The lesion was hypodense on CT scan and was hypervascularized on angiography. NMR was hypointense on T1 and hyperintense on T2. The patient underwent surgery with intraoperative biopsy being performed. Hepatectomy was not carried out given negativity of malignancy. Following surgery the patient remained asymptomatic and the analytical alterations normalized. After a asymptomatic 5-year period the clinical-analytical alterations reappeared following erysipelas. Fever showed partial response to non steroid antiinflammatory drugs and a satisfactory response to corticoids. Studies are required to evaluate the role of corticoid treatment in this disease.
报告了一例新的肝脏炎性假瘤（HIP）病例。一名66岁女性出现发热和中毒综合征。分析显示红细胞沉降率、CRP、白细胞增多和正细胞性贫血升高。超声检查发现右肝叶低回声区有一个病变，内部有回声（马赛克样）。CT扫描显示该病变为低密度，血管造影显示其血管丰富。核磁共振成像（NMR）在T1加权像上呈低信号，在T2加权像上呈高信号。患者接受了手术，并进行了术中活检。由于未发现恶性病变，未进行肝切除术。术后患者无症状，分析指标恢复正常。在无症状的5年期间后，丹毒发作后临床分析指标再次出现异常。发热对非甾体抗炎药有部分反应，对皮质类固醇有满意反应。需要进行研究以评估皮质类固醇治疗在该疾病中的作用。
