Schiappacasse F Giancarlo, Vallejos C Antonio, Figueroa D Paula, Salcedo R Amilcar, Bustamante M Caroll, Humeres A Roberto
Hospital Militar de Santiago, Facultad de Medicina, Universidad de Santiago de Chile, Santiago, Chile.
Hospital Militar, Santiago, Chile.
Rev Med Chil. 2023 Sep;151(9):1255-1259. doi: 10.4067/s0034-98872023000901255.
We report the case of a 49-year-old man who attended the emergency department for a two-month history of compromised general condition, weight loss, abdominal pain, fever, and elevated inflammatory parameters. An imaging study demonstrates a bulky liver tumor associated with dilation of the bile duct and retroperitoneal adenopathies (hepatic hilum, intermediate, and right lumbar groups). These findings raise intrahepatic cholangiocarcinoma within the differential diagnoses, reason why segmental hepatectomy and regional lymphadenectomy were performed. Histopathology and immunochemistry revealed a lymphoplasmacytic inflammatory process with IgG4-positive plasma cells compatible with IgG4-associated disease. After the resection, expectant management was decided, with the patient evolving favorably, asymptomatic, and without signs of recurrence. We present a case and a brief literature review of an hepatic inflammatory pseudotumor, a rare entity with a benign behavior.
我们报告了一名49岁男性的病例,他因全身状况不佳、体重减轻、腹痛、发热以及炎症参数升高达两个月之久而前往急诊科就诊。一项影像学研究显示,存在一个体积较大的肝脏肿瘤,伴有胆管扩张和腹膜后淋巴结肿大(肝门、中间和右腰组)。这些发现使肝内胆管癌进入鉴别诊断范围,因此实施了肝段切除术和区域淋巴结清扫术。组织病理学和免疫化学检查显示为淋巴细胞浆细胞性炎症过程,伴有IgG4阳性浆细胞,符合IgG4相关疾病。切除术后,决定采取观察等待的处理方式,患者病情进展良好,无症状且无复发迹象。我们展示了一例肝脏炎性假瘤病例并进行简要文献回顾,这是一种行为良性的罕见病症。