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肝脏炎性假瘤:既往有胆道手术史患者的重要鉴别诊断

Hepatic Inflammatory Pseudotumor: An Important Differential Diagnosis in Patients With a History of Previous Biliary Procedures.

作者信息

Zhao Jianping, Olino Kelly, Low Leah E, Qiu Suimin, Stevenson Heather L

机构信息

Department of Pathology, University of Texas Medical Branch, Galveston, TX.

Department of Surgery, University of Texas Medical Branch, Galveston, TX.

出版信息

ACG Case Rep J. 2019 Feb 13;6(1):e00015. doi: 10.14309/crj.0000000000000015. eCollection 2019 Jan.

Abstract

Hepatic inflammatory pseudotumors (IPTs) are rare lesions that mimic malignancy clinically, radiologically, and pathologically. The pathophysiology is unknown, and no criteria exist for diagnosis. This series includes 3 cases: 1 patient had recent biliary drainage with bile duct stent placement, and the other 2 patients had hepatic abscess formation before IPT development, which further supports that hepatic IPTs develop in patients with underlying triggers of liver inflammation and injury, including infections and/or bile leakage into the parenchyma. All 3 patients were successfully treated with antibiotics, sparing them surgical intervention. Follow-up showed complete resolution, and none developed recurrences or malignancies.

摘要

肝脏炎性假瘤(IPT)是一种罕见病变,在临床、放射学和病理学上都酷似恶性肿瘤。其病理生理学尚不清楚,也没有诊断标准。本系列包括3例:1例患者近期进行了胆管引流并放置了胆管支架,另外2例患者在IPT发生前有肝脓肿形成,这进一步支持肝脏IPT发生于有肝脏炎症和损伤潜在诱因的患者,包括感染和/或胆汁渗入实质。所有3例患者均通过抗生素治疗成功治愈,避免了手术干预。随访显示病变完全消退,无一例复发或发生恶性肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e21/6657982/5aafa21ebce8/ac9-6-e00015-g001.jpg

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