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伴有肝实质萎缩的假性淋巴瘤:一例报告。

Pseudolymphoma with atrophic parenchyma of the liver: Report of a case.

作者信息

Takahashi Yusuke, Seki Hitoshi, Sekino Yasushi

机构信息

Department of Digestive Surgery, Nagano Municipal Hospital, Nagano, 381-8551, Japan.

Department of Digestive Surgery, Nagano Municipal Hospital, Nagano, 381-8551, Japan.

出版信息

Int J Surg Case Rep. 2018;49:136-139. doi: 10.1016/j.ijscr.2018.06.033. Epub 2018 Jun 28.

Abstract

INTRODUCTION

Pseudolymphoma of the liver is a very rare disease. It is usually resected and pathologically diagnosed because of the difficulty of discrimination from the malignant neoplasm. For this reason, few cases which were observed for several years have been reported. We present a case of this disease observed and slightly enlarged for two years.

PRESENTATION OF CASES

The patient was a 46-year-old woman who underwent laparoscopic partial nephrectomy for right renal cell carcinoma two years ago. The preoperative computed tomography (CT) showed the mass 7 mm in diameter with localized parenchymal atrophy of the liver (segment Ⅵ). Two years later, CT showed enlarged mass from 7 to 11 mm in diameter. We performed laparoscopic partial hepatectomy because the patient desired definite diagnosis by surgery. The resected specimen showed white and solid mass. The lymphocyte and plasma cells are histologically observed. Immunohistological staining showed CD10 positive, Bcl-2 negative, and cyclin D1 negative. The pathological diagnosis was pseudolymphoma of the liver.

DISCUSSION

Pseudolymphoma is rarely observed in the liver. It is reported that chronic hepatitis, collagen diseases, and malignant diseases were often accompanied, but detail pathogenesis has been unknown. She had the history of renal carcinoma, but the lesion was not vanished regardless of clearance of renal neoplasm. Surgical resection is usually performed because discrimination with malignant neoplasm is difficult. The present case is probably the first one, which is followed for long term duration.

CONCLUSION

The present case may contribute to clarify the pathophysiology of this entity.

摘要

引言

肝脏假性淋巴瘤是一种非常罕见的疾病。由于难以与恶性肿瘤相鉴别,通常会进行切除并做病理诊断。因此,很少有报道观察数年的病例。我们报告一例观察两年且略有增大的该疾病病例。

病例介绍

患者为一名46岁女性,两年前因右肾细胞癌接受了腹腔镜下部分肾切除术。术前计算机断层扫描(CT)显示肝脏(Ⅵ段)有一个直径7毫米的肿块,伴有局部实质萎缩。两年后,CT显示肿块直径从7毫米增大到11毫米。由于患者希望通过手术明确诊断,我们进行了腹腔镜下部分肝切除术。切除的标本显示为白色实性肿块。组织学观察到淋巴细胞和浆细胞。免疫组织化学染色显示CD10阳性,Bcl-2阴性,细胞周期蛋白D1阴性。病理诊断为肝脏假性淋巴瘤。

讨论

肝脏假性淋巴瘤很少见。据报道,其常伴有慢性肝炎、胶原病和恶性疾病,但具体发病机制尚不清楚。她有肾癌病史,但尽管肾肿瘤已清除,病变并未消失。由于难以与恶性肿瘤相鉴别,通常会进行手术切除。本病例可能是首例长期随访的病例。

结论

本病例可能有助于阐明该疾病的病理生理学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc2/6037881/e82955798dea/gr1.jpg

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