Fu Li-Yue, Jiang Jiu-Liang, Liu Meng, Li Jun-Jun, Liu Kai-Ping, Zhu Hai-Tao
Clinical School, Guizhou Medical University, Guiyang 550001, Guizhou Province, China.
Department of Hepatobiliary Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China.
World J Gastrointest Oncol. 2022 Nov 15;14(11):2288-2294. doi: 10.4251/wjgo.v14.i11.2288.
Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is rare with a low malignant potential. Hepatic IPT-like FDCS has similar clinical features to hepatocellular carcinoma (HCC), making it extremely difficult to distinguish between them in clinical practice. We describe the case of a young female patient diagnosed with HCC before surgery, which was pathologically diagnosed as IPT-like FDCS after the left half of the liver was resected. During 6 mo of follow-up, the patient recovered well with no signs of recurrence or metastasis.
A 23-year-old female patient with a 2-year history of hepatitis B presented to the Affiliated Hospital of Guizhou Medical University. She was asymptomatic at presentation, and the findings from routine laboratory examinations were normal except for slightly elevated alpha-fetoprotein levels. However, ultrasonography revealed a 3-cm diameter mass in the left hepatic lobe, and abdominal contrast-enhanced computed tomography revealed that the tumor had asymmetrical enhancement during the arterial phase, which declined during the portal venous phase, and had a pseudo-capsule appearance. Based on the findings from clinical assessments and imaging, the patient was diagnosed with HCC, for which she was hospitalized and had undergone laparoscopic left hepatectomy. However, the tumor specimens submitted for pathological analyses revealed IPT-like FDCS. After surgical removal of the tumor, the patient recovered. In addition, the patient continued to recover well during 6 mo of follow-up.
Hepatic IPT-like FDCS is difficult to distinguish from HCC. Hepatectomy may provide beneficial outcomes in non-metastatic hepatic IPT-like FDCS.
炎性假瘤样滤泡树突状细胞肉瘤(IPT样FDCS)罕见,恶性潜能低。肝脏IPT样FDCS的临床特征与肝细胞癌(HCC)相似,这使得在临床实践中极难区分两者。我们描述了一名年轻女性患者的病例,该患者术前被诊断为HCC,在左半肝切除术后病理诊断为IPT样FDCS。在6个月的随访期间,患者恢复良好,无复发或转移迹象。
一名有2年乙肝病史的23岁女性患者就诊于贵州医科大学附属医院。就诊时无症状,除甲胎蛋白水平略有升高外,常规实验室检查结果正常。然而,超声检查发现左肝叶有一个直径3厘米的肿块,腹部增强计算机断层扫描显示肿瘤在动脉期有不对称强化,在门静脉期下降,并有假包膜外观。根据临床评估和影像学检查结果,该患者被诊断为HCC,为此她住院并接受了腹腔镜左肝切除术。然而,提交病理分析的肿瘤标本显示为IPT样FDCS。手术切除肿瘤后,患者康复。此外,在6个月的随访期间,患者继续恢复良好。
肝脏IPT样FDCS难以与HCC区分。肝切除术可能对非转移性肝脏IPT样FDCS有益。