Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, Okazaki, Japan.
Department of Diagnostic Pathology, Fujita Health University School of Medicine Okazaki Medical Center, Okazaki, Japan.
Asian J Endosc Surg. 2023 Jul;16(3):621-626. doi: 10.1111/ases.13202. Epub 2023 Jun 6.
Inflammatory pseudotumor (IPT) is a rare disease that requires a differential diagnosis from malignancies. We describe a case of hepatic IPT with para-aortic lymphadenopathy, treated with a stepwise strategy of laparoscopic surgery. A 61-year-old woman was referred with a liver lesion. Computed tomography revealed a 13 cm well-defined lesion in segments VII-VI. The patient also had bead-like enlarged lymph nodes from the perihilar to the para-aortic regions. Although percutaneous lymph node biopsy showed no evidence of malignancy, F-fluorodeoxyglucose positron emission tomography revealed accumulation in the lesion and lymph nodes. Lymph nodes were harvested laparoscopically for intraoperative pathological examination. With no evidence of malignancy, laparoscopic liver resection was continuously performed as a diagnostic treatment. The patient was given a pathological diagnosis of IPT and was discharged on the 16th day and is well 2 years after surgery. The minimally invasive laparoscopic approach to diagnostic treatment could be useful with secure advantages.
炎性假瘤（IPT）是一种罕见的疾病，需要与恶性肿瘤进行鉴别诊断。我们描述了一例伴有腹主动脉旁淋巴结病的肝 IPT 病例，该病例采用逐步腹腔镜手术策略进行治疗。一名 61 岁女性因肝脏病变就诊。计算机断层扫描显示在第七和第六段有一个 13 厘米界限清楚的病变。该患者还存在从肝门到腹主动脉区域呈珠状增大的淋巴结。虽然经皮淋巴结活检未发现恶性肿瘤的证据，但 F-氟脱氧葡萄糖正电子发射断层扫描显示病变和淋巴结有积聚。为了进行术中病理检查，对淋巴结进行了腹腔镜采集。由于没有恶性肿瘤的证据，继续进行腹腔镜肝切除术作为诊断性治疗。患者的病理诊断为 IPT，术后第 16 天出院，术后 2 年情况良好。微创腹腔镜诊断性治疗方法具有安全优势。
