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肝脏反应性淋巴组织增生:一例报告

Reactive lymphoid hyperplasia of the liver: A case report.

作者信息

Zhang Wenyan, Zheng Shusen

机构信息

Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2019 Jul;98(30):e16491. doi: 10.1097/MD.0000000000016491.

Abstract

RATIONALE

Reactive lymphoid hyperplasia (RLH) of the liver is an uncommon benign lesion. It is usually difficult to differentiate from hepatocellular carcinoma (HCC), peripheral-type cholangiocellular carcinoma (CCC), combined HCC-CCC, and liver metastases. On account of its rarity and controversial issues, we report a case report and review the literature to discuss its clinical features, treatments, radiological, and immunohistochemical characteristics.

PATIENT CONCERNS

A 54-year-old woman had a history of primary biliary cirrhosis and chronic cholecystitis. She complained of finding a lesion in the right liver during her last medical check-up by abdominal B type ultrasound. The Contrast-enhanced computed tomography revealed a circular and low-density lesion in the right posterior lobe of the liver, approximately 22.0 × 18.7 mm in size. On magnetic resonance imaging, the lesion showed low-signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Laboratory test results were almost normal.

DIAGNOSIS

After the postoperative pathological and immunohistochemical examination, the patient was finally diagnosed as having RLH.

INTERVENTIONS

The patient received right posterior lobe hepatectomy and cholecystectomy.

OUTCOMES

The patient was discharged 11 days after surgery. No evidence of recurrence was noted 1 year after the surgery.

LESSONS

Although RLH of the liver is rare, it is necessary to be considered in a liver lesion, especially in female patients. This case report may advance the understanding of RLH of the liver and reduce the number of mistakenly diagnosed patients.

摘要

理论依据

肝脏反应性淋巴组织增生(RLH)是一种罕见的良性病变。它通常很难与肝细胞癌(HCC)、周围型胆管细胞癌(CCC)、HCC-CCC混合型以及肝转移瘤相鉴别。鉴于其罕见性和存在争议的问题,我们报告一例病例并复习文献,以探讨其临床特征、治疗方法、影像学及免疫组化特征。

患者情况

一名54岁女性,有原发性胆汁性肝硬化和慢性胆囊炎病史。她在最近一次腹部B型超声体检时发现肝脏右叶有一个病变。增强计算机断层扫描显示肝脏右后叶有一个圆形低密度病变,大小约为22.0×18.7mm。在磁共振成像上,该病变在T1加权图像上呈低信号强度,在T2加权图像上呈高信号强度。实验室检查结果基本正常。

诊断

术后经病理及免疫组化检查,患者最终被诊断为RLH。

干预措施

患者接受了右后叶肝切除术和胆囊切除术。

结果

患者术后11天出院。术后1年未发现复发迹象。

经验教训

尽管肝脏RLH罕见,但对于肝脏病变,尤其是女性患者,有必要考虑到这种疾病。本病例报告可能会增进对肝脏RLH的理解,并减少误诊患者的数量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f526/6709198/d305cdabe895/medi-98-e16491-g001.jpg

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