Fritzsch J, Richter M, Edelmann C, Lange R, Tannapfel A
Abteilung für Innere Medizin, HELIOS Klinik Zwenkau.
Internist (Berl). 2004 Jun;45(6):713-6. doi: 10.1007/s00108-004-1195-6.
A 35 year old male suffered from fever till 39 degrees C and malaise since 6 months; infectious or neoplastic causes have been ruled out. Ultrasonography revealed a hypoechoic lesion of 75 mm diameter in the liver. The histologic examination of the needle biopsy showed an inflammatory process, and the final diagnosis was inflammatory pseudotumor. EBV specific LMP-1 protein was detected within the tumor immunohistochemically. A liver segment resection was performed, and the patient has been well and without fever since then for 18 months. Inflammatory pseudotumor is a rare but important differential diagnosis in cases of hypoechoic liver lesions associated by fever, if there is no abscess or malignancy. The diagnosis must be confirmed histologically, because imaging techniques cannot reliably classify the lesion.
一名35岁男性,6个月来持续发热至39摄氏度并伴有全身不适;已排除感染性或肿瘤性病因。超声检查显示肝脏有一个直径75毫米的低回声病变。针吸活检的组织学检查显示为炎症过程,最终诊断为炎性假瘤。免疫组织化学检测发现肿瘤内存在EBV特异性LMP-1蛋白。进行了肝段切除术,此后患者状况良好,18个月来未再发热。炎性假瘤是伴有发热的肝脏低回声病变病例中一种罕见但重要的鉴别诊断,前提是不存在脓肿或恶性肿瘤。诊断必须通过组织学确认,因为影像学技术无法可靠地对病变进行分类。