Yoshida Toshinori, Nishimori Isao, Kumon Masamitsu, Kohsaki Takuhiro, Taniuchi Keisuke, Ohtsuki Yuji, Onishi Saburo
Noichi Central Hospital, Noichi, 781-5213, Kochi, Japan
Hepatol Res. 2003 Sep;27(1):83-86. doi: 10.1016/s1386-6346(03)00159-1.
We report a case of a 76-year-old man with inflammatory pseudotumor, xanthogranuloma type of the liver. The patient showed clinical manifestations of a liver abscess. Abdominal sonography and computed tomography revealed an additional tumor-like lesion adjoining the liver abscess. Following treatment with antibiotics for 20 days, the liver abscess disappeared, but there was no change in the size and shape of the tumor-like lesion. Histological analysis of a specimen obtained from the tumor-like lesion by needle biopsy revealed an infiltration of abundant foamy histiocytes with massive fibrosis. Without any treatment, the tumor-like lesion gradually diminished in 5 months. In previous literatures, most cases with xanthogranuloma of the liver underwent hepatectomy or diagnostic laparotomy. The findings presented herein suggest that in cases of an atypical solid mass in the liver accompanied by a clinical inflammatory process, inflammatory pseudotumor should be considered, and, if the disease is suspected, liver needle biopsy is recommended to prevent an unnecessary surgical operation.
我们报告一例76岁男性患肝脏黄色肉芽肿型炎性假瘤的病例。患者表现出肝脓肿的临床表现。腹部超声和计算机断层扫描显示在肝脓肿旁有一个额外的肿瘤样病变。用抗生素治疗20天后，肝脓肿消失，但肿瘤样病变的大小和形状没有变化。通过针吸活检从肿瘤样病变获取的标本进行组织学分析，显示有大量泡沫状组织细胞浸润并伴有大量纤维化。未经任何治疗，肿瘤样病变在5个月内逐渐缩小。在以往文献中，大多数肝脏黄色肉芽肿病例都接受了肝切除术或诊断性剖腹手术。本文呈现的研究结果表明，对于肝脏中伴有临床炎症过程的非典型实性肿块病例，应考虑炎性假瘤，并且，如果怀疑患有该病，建议进行肝脏针吸活检以避免不必要的外科手术。
