Kim S R, Hayashi Y, Kang K B, Soe C G, Kim J H, Yang M K, Itoh H
Department of Gastroenterology, Kobe Asahi Hospital, Japan.
J Hepatol. 1997 Jan;26(1):209-14. doi: 10.1016/s0168-8278(97)80028-1.
A case of pseudolymphoma (reactive lymphoid hyperplasia) of the liver in a 72-year-old male with chronic hepatitis C is presented. Imaging studies, comprising ultrasonography, computed tomography, incremental computed tomography, and magnetic resonance imaging, suggested hepatocellular carcinoma. A tumor-like lesion was therefore resected. Grossly, the lesion was relatively poorly defined and measured 15 x 17 mm; microscopically, it consisted of lymphocytic proliferations forming follicles comprising numerous germinal centers that were mainly composed of L-26 positive B-cell lymphocytes. The lymphocytes surrounding germinal centers were mainly UCHL-1 positive T lymphocytes. The B cells in the lymphoid follicles stained positive for both kappa and lambda light chains at sequential frequencies, indicating polyclonal and benign features. These findings suggest that the diagnosis of pseudolymphoma of the liver is tenable from imaging studies supplemented, when necessary, with biopsy. Further studies may provide insights into diagnostic strategies and the mechanism of stimulation in HCV infections.
本文报告了一例72岁慢性丙型肝炎男性患者的肝脏假性淋巴瘤（反应性淋巴样增生）病例。包括超声、计算机断层扫描、动态计算机断层扫描和磁共振成像在内的影像学检查提示为肝细胞癌。因此切除了一个肿瘤样病变。大体上，病变边界相对不清，大小为15×17mm；显微镜下，病变由形成滤泡的淋巴细胞增殖组成，滤泡包含许多生发中心，主要由L-26阳性B淋巴细胞组成。生发中心周围的淋巴细胞主要是UCHL-1阳性T淋巴细胞。淋巴滤泡中的B细胞κ和λ轻链呈序贯性阳性染色，表明具有多克隆和良性特征。这些发现表明，肝脏假性淋巴瘤的诊断在影像学检查基础上必要时辅以活检是成立的。进一步的研究可能会为丙型肝炎病毒感染的诊断策略和刺激机制提供见解。
