Department of Radiology, Hunan Provincial People's Hospital (the First Affiliate Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China.
Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China.
World J Gastroenterol. 2019 Dec 7;25(45):6693-6703. doi: 10.3748/wjg.v25.i45.6693.
Inflammatory pseudotumor-like follicular dendritic cell (IPT-like FDC) tumors of the liver is an uncommon tumor with extremely low incidence. To date, the radiologic findings of this tumor in multiphase computed tomography (CT) and magnetic resonance imaging (MRI) imaging have not been described.
Patient 1 is a 31-year-old Chinese female, whose complaining incidentally coincided with the finding of multiple liver masses. In the local hospital, an abdominal enhanced CT found two hypo-dense solid lesions, with heterogeneous sustained hypoenhancement, in the upper segment of the liver's right posterior lobe. In our hospital, enhanced magnetic resonance imaging (MRI) with hepatocyte-specific contrast agents showed a similar enhanced pattern of lesions with patchy hyperintensity in the hepatobiliary phase (HBP). The patient underwent surgery and recovered well. The final pathology confirmed an IPT-like FDC tumor. No recurrence was found on the regular re-examination. Patient 2 is a 48-year-old Chinese male admitted to our hospital for a huge unexpected hepatic lesion. A dynamic enhanced abdominal CT revealed a huge heterogeneous enhanced solid tumor in the right lobe of the liver with a size of 100 mm × 80 mm, which showed a heterogeneous sustained hypoenhancement. In addition, enlarged lymph nodes were found in the hilum of the liver. This patient underwent a hepatic lobectomy and lymph node dissection. The final pathology confirmed an IPT-like FDC tumor. No recurrence was found upon regular re-examination.
When a hepatic tumor shows heterogeneous sustained hypoenhancement with a patchy enhancement during HBP, an IPT-like FDC tumor should be considered in the differential diagnosis.
肝炎性假瘤样滤泡树突状细胞(IPT 样 FDC)肿瘤是一种罕见的肿瘤,发病率极低。迄今为止,尚未描述该肿瘤在多期 CT 和 MRI 成像中的放射学表现。
患者 1 为 31 岁中国女性,因多处肝肿块偶然发现。在当地医院,腹部增强 CT 发现肝右后叶上段有两个低密实性病变,呈不均匀持续低增强。在我院,肝特异性对比剂增强 MRI 显示病变呈类似增强模式,肝胆期(HBP)呈斑片状高信号。患者接受手术,恢复良好。最终病理证实为 IPT 样 FDC 肿瘤。定期复查未见复发。患者 2 为 48 岁中国男性,因巨大意外肝病变入院。动态增强腹部 CT 显示肝右叶有一个巨大的不均匀强化实性肿瘤,大小为 100mm×80mm,呈不均匀持续低增强。此外,肝门处还发现了增大的淋巴结。该患者接受了肝叶切除术和淋巴结清扫术。最终病理证实为 IPT 样 FDC 肿瘤。定期复查未见复发。
当肝肿瘤在 HBP 期间表现为不均匀持续低增强伴斑片状增强时,应考虑 IPT 样 FDC 肿瘤的鉴别诊断。