Yoon K H, Ha H K, Lee J S, Suh J H, Kim M H, Kim P N, Lee M G, Yun K J, Choi S C, Nah Y H, Kim C G, Won J J, Auh Y H
Dept of Diagnostic Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Radiology. 1999 May;211(2):373-9. doi: 10.1148/radiology.211.2.r99ma36373.
To correlate computed tomographic (CT) features of inflammatory pseudotumors of the liver with histopathologic results in patients with recurrent pyogenic cholangitis.
CT features of 13 cases of inflammatory hepatic pseudotumor in 10 patients with recurrent pyogenic cholangitis were reviewed. Diagnosis was made by means of surgical resection in all patients. CT scans were analyzed for the appearance of masses and ancillary findings in correlation with the histopathologic findings in each resected specimen.
The masses were 2.0-7.0 cm (mean, 3.5 cm). At nonenhanced CT, the masses appeared as ill-defined, hypoattenuating lesions. At contrast material-enhanced CT, the masses exhibited central hypoattenuating areas with an iso- or hyperattenuating thickened periphery in four cases and a multiseptate appearance with hyperattenuating internal septa and periphery in nine cases. CT-histopathologic correlation showed that the central hypoattenuating area indicated the presence of chronic inflammatory infiltrates with foamy histiocytes, plasmacytes, and lymphocytes, while iso- or hyperattenuating areas in the periphery and internal septa of the mass represented fibroblastic proliferation. All patients had CT features of recurrent pyogenic cholangitis, such as hepatolithiasis, intrahepatic duct stricture and dilatation, common bile duct calculi, pneumobilia, or parenchymal atrophy.
Although CT features are not specific, inflammatory pseudotumor should be included in the differential diagnosis in patients with recurrent pyogenic cholangitis and a hepatic mass detected at CT.
将复发性化脓性胆管炎患者肝脏炎性假瘤的计算机断层扫描（CT）特征与组织病理学结果进行关联。
回顾了10例复发性化脓性胆管炎患者中13例肝脏炎性假瘤的CT特征。所有患者均通过手术切除进行诊断。分析CT扫描中肿块的表现及相关辅助征象，并与每个切除标本的组织病理学结果进行关联。
肿块大小为2.0 - 7.0 cm（平均3.5 cm）。在平扫CT上，肿块表现为边界不清的低密度病变。在对比剂增强CT上，4例肿块表现为中央低密度区，周边有等密度或高密度增厚，9例表现为多房性，内部间隔和周边为高密度。CT与组织病理学的相关性显示，中央低密度区提示存在伴有泡沫状组织细胞、浆细胞和淋巴细胞的慢性炎性浸润，而肿块周边和内部间隔的等密度或高密度区代表成纤维细胞增生。所有患者均有复发性化脓性胆管炎的CT特征，如肝内胆管结石、肝内胆管狭窄和扩张、胆总管结石、气肿性胆囊炎或实质萎缩。
虽然CT特征不具有特异性，但对于复发性化脓性胆管炎且CT检查发现肝脏肿块的患者，炎性假瘤应列入鉴别诊断。
