Department of Gastroenterology and Hepatology, Osaka University Hospital, 2-15, Yamadaoka, Suita 565-0871, Japan.
World J Gastroenterol. 2012 Jan 7;18(1):90-5. doi: 10.3748/wjg.v18.i1.90.
An inflammatory pseudotumor (IPT) is a relatively rare lesion characterized by chronic infiltration of inflammatory cells and areas of fibrosis. IPTs are difficult to diagnose because of the absence of specific symptoms or of characteristic hematological or radiological findings. In this study, a case of a woman aged over 70 years was reported, who presented with a general malaise lasting more than two months. A computed tomography scan demonstrated a diffusely spread lesion of the liver with a portal vein occlusion and a splenic lesion surrounded by a soft density layer. Since the percutaneous liver biopsy showed findings that suggested an IPT, although the radiological findings did not exclude the possibility of a malignancy, we performed a percutaneous spleen biopsy to enable a more definitive diagnosis. The microscopic findings from the spleen specimen lead us to a diagnosis of IPT involving the liver and spleen. Subsequent steroid pulse therapy was effective, and rapid resolution of the disease was observed.
炎性假瘤(IPT)是一种相对罕见的病变,其特征为慢性浸润的炎症细胞和纤维化区域。由于缺乏特异性症状或特征性血液学或影像学发现,IPT 难以诊断。本研究报告了一例 70 多岁的女性病例,该患者出现持续两个多月的全身不适。计算机断层扫描显示肝脏弥漫性病变,伴有门静脉阻塞和脾脏病变,周围有一层软密度层。由于经皮肝活检显示的结果提示为 IPT,尽管影像学检查不排除恶性肿瘤的可能性,但我们进行了经皮脾活检以做出更明确的诊断。脾脏标本的显微镜检查结果提示我们诊断为累及肝脏和脾脏的 IPT。随后的类固醇脉冲治疗有效,疾病迅速缓解。