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肝内反应性淋巴组织增生:一例报告并文献复习

Intrahepatic Reactive Lymphoid Hyperplasia: A Case Report and Review of the Literature.

作者信息

Seitter Samantha, Goodman Zachary D, Friedman Theodore M, Shaver Timothy R, Younan George

机构信息

Department of Surgery, Inova Fairfax Hospital, Fairfax, VA, USA.

Department of Pathology, Inova Fairfax Hospital, Fairfax, VA, USA.

出版信息

Case Rep Surg. 2018 Sep 6;2018:9264251. doi: 10.1155/2018/9264251. eCollection 2018.

Abstract

INTRODUCTION

Reactive lymphoid hyperplasia (RLH) is a rare and benign lesion found in organs of the gastrointestinal tract, skin, lung, orbit, and more rarely in the liver. Due to its similar appearance on imaging, it is hard to differentiate from primary liver malignancies. The following is a case report of a patient presenting with a suspicious liver lesion found to be RLH associated with primary biliary cirrhosis (PBC), after surgical resection.

PRESENTATION OF CASE

A 54-year-old woman presented with nonspecific abdominal pain, and her workup included axial imaging of the abdomen that showed a suspicious lesion in her liver. After an extensive workup, which included a percutaneous biopsy, failed to confirm a diagnosis, a laparoscopic surgical resection was recommended.

DISCUSSION

RLH is a rare condition of the liver, presenting in a suspicious fashion and raising concerns for a primary liver malignancy. RLH should be considered in the differential diagnosis of small hepatic lesions in middle-age females in the absence of any significant risk factors for hepatocellular carcinoma (HCC). RLH tends to be associated with PBC of the liver.

CONCLUSION

RLH of the liver is a rare, hard to diagnose, benign lesion. When intrahepatic, it cannot be easily differentiated from primary liver tumors and frequently requires surgical resection for pathological diagnostic confirmation.

摘要

引言

反应性淋巴组织增生(RLH)是一种罕见的良性病变,见于胃肠道、皮肤、肺、眼眶等器官,在肝脏中更为罕见。由于其在影像学上的表现相似,很难与原发性肝脏恶性肿瘤区分开来。以下是一例患者的病例报告,该患者在手术切除后,发现肝脏可疑病变为与原发性胆汁性肝硬化(PBC)相关的RLH。

病例介绍

一名54岁女性因非特异性腹痛就诊,其检查包括腹部轴向成像,显示肝脏有可疑病变。在进行了包括经皮活检在内的广泛检查未能确诊后,建议进行腹腔镜手术切除。

讨论

RLH是一种罕见的肝脏疾病,以可疑的方式出现,引发对原发性肝脏恶性肿瘤的担忧。在没有任何显著肝细胞癌(HCC)风险因素的中年女性中,鉴别诊断肝脏小病变时应考虑RLH。RLH往往与肝脏的PBC相关。

结论

肝脏RLH是一种罕见、难以诊断的良性病变。当病变位于肝内时,它不易与原发性肝脏肿瘤区分开来,通常需要手术切除以进行病理诊断确认。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0754/6146636/4e2383f2f4c9/CRIS2018-9264251.001.jpg

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