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Z Gastroenterol 2003; 41(10): 991-994
DOI: 10.1055/s-2003-42928
Kasuistik
© Karl Demeter Verlag im Georg Thieme Verlag Stuttgart · New York

Spontaneous Regression of an Inflammatory Pseudotumor of the Liver

Spontane Regression eines inflammatorischen Pseudotumors der LeberE. Biecker1 , A. Zimmermann2 , J.-F Dufour1
  • 1Institut für klinische Pharmakologie, Universität Bern, Schweiz
  • 2Pathologisches Institut, Universität Bern, Schweiz
Further Information

Publication History

Manuscript received: 13. December 2002

Accepted after revision: 16. June 2003

Publication Date:
16 October 2003 (online)

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Zusammenfassung

Inflammatorische Pseudotumoren (IPT) wurden für fast alle Organe und Gewebe beschrieben, finden sich aber nur selten in der Leber. Klinisch präsentieren sich die Patienten in der Regel mit Fieber, Abgeschlagenheit, Gewichtsverlust und oft mit einer Raumforderung im Oberbauch. Die bildgebenden Verfahren allein erlauben in der Regel keine sichere Diagnose, insbesondere die Abgrenzung zu Neoplasien ist schwierig. Prinzipiell ist eine Biopsie zur Diagnosesicherung unumgänglich. Der klinische Verlauf ist meist benigne, allerdings sind aggressive Verlaufsformen bekannt. Bei einem Großteil der beschriebenen Patienten wurde eine Resektion vorgenommen oder die Patienten wurden medikamentös behandelt. Wir schildern eine Patientin mit histologisch gesichertem IPT der Leber, bei der der IPT sich über einige Monate spontan und ohne spezifische Therapie zurückentwickelte.

Abstract

Inflammatory pseudotumors (IPT) have been described for virtually every site in the body but is rare in the liver. The clinical presentation of hepatic IPT is unspecific, patients complain of fever, malaise, weight loss and often of symptoms related to a mass effect. Routine imaging procedures are not sufficient to make the diagnosis and a biopsy is necessary to differentiate IPT from neoplasms. The course of the disease is unpredictable and in most of the reported cases the patients underwent resection or were medically treated. We report a patient with a histologically proven IPT of the liver that regressed spontaneously over several months without any specific treatment.

Schlüsselwörter

Inflammatorischer Pseudotumor - Lebertumor

Key words

Inflammatory pseudotumor - liver tumor

References

  • 1 Zavaglia C, Barberis M, Gelosa F. et al . Inflammatory pseudotumour of the liver with malignant transformation. Report of two cases.  Ital J Gastroenterol. 1996;  28 152-159
    PubMedGoogle Scholar
  • 2 Voss S D, Kruskal J B, Kane R A. Chronic inflammatory pseudotumor arising in the hepatobiliary-pancreatic system: progressive multisystemic organ involvement in four patients.  AJR Am J Roentgenol. 1999;  173 1049-1054
    PubMedGoogle Scholar
  • 3 Coffin C M, Humphrey P A, Dehner L P. Extrapulmonary inflammatory myofibroblastic tumor: a clinical and pathological survey.  Semin Diagn Pathol. 1998;  15 85-101
    CrossrefPubMedGoogle Scholar
  • 4 Trotter J F, Everson G T. Benign focal lesions of the liver.  Clin Liver Dis. 2001;  5 17-42
    Google Scholar
  • 5 Gollapudi P, Chejfec G, Zarling E J. Spontaneous regression of hepatic pseudotumor.  Am J Gastroenterol. 1992;  87 214-217
    PubMedGoogle Scholar
  • 6 Anthony P P, Telesinghe P U. Inflammatory pseudotumour of the liver.  J Clin Pathol. 1986;  39 761-768
    CrossrefPubMedGoogle Scholar
  • 7 Ishida H, Tatsuta M, Furukawa H. et al . Multiple inflammatory pseudotumors mimicking liver metastasis from colon cancer: report of a case.  Surg Today. 2000;  30 530-533
    CrossrefPubMedGoogle Scholar
  • 8 Fukuya T, Honda H, Matsumata T. et al . Diagnosis of inflammatory pseudotumor of the liver: value of CT.  AJR Am J Roentgenol. 1994;  163 1087-1091
    PubMedGoogle Scholar
  • 9 Abehsera M, Vilgrain V, Belghiti J. et al . Inflammatory pseudotumor of the liver: radiologic-pathologic correlation.  J Comput Assist Tomogr. 1995;  19 80-83
    PubMedGoogle Scholar
  • 10 Flisak M E, Budris D M, Olson M C. et al . Inflammatory pseudotumor of the liver: appearance on MRI.  Clin Imaging. 1994;  18 1-3
    CrossrefPubMedGoogle Scholar
  • 11 Nakanuma Y, Tsuneyama K, Masuda S. et al . Hepatic inflammatory pseudotumor associated with chronic cholangitis: report of three cases.  Hum Pathol. 1994;  25 86-91
    CrossrefPubMedGoogle Scholar
  • 12 Shek T W, Ng I O, Chan K W. Inflammatory pseudotumor of the liver. Report of four cases and review of the literature.  Am J Surg Pathol. 1993;  17 231-238
    PubMedGoogle Scholar
  • 13 Broughan T A, Fischer W L, Tuthill R J. Vascular invasion by hepatic inflammatory pseudotumor. A clinicopathologic study.  Cancer. 1993;  71 2934-2940
    PubMedGoogle Scholar
  • 14 Arber D A, Weiss L M, Chang K L. Detection of Epstein-Barr Virus in inflammatory pseudotumor.  Semin Diagn Pathol. 1998;  15 155-160
    PubMedGoogle Scholar
  • 15 Cheuk W, Chan J K, Shek T W. et al . Inflammatory pseudotumor-like follicular dendritic cell tumor: a distinctive low-grade malignant intra-abdominal neoplasm with consistent Epstein-Barr virus association.  Am J Surg Pathol. 2001;  25 721-731
    CrossrefPubMedGoogle Scholar
  • 16 Selves J, Meggetto F, Brousset P. et al . Inflammatory pseudotumor of the liver. Evidence for follicular dendritic reticulum cell proliferation associated with clonal Epstein-Barr virus.  Am J Surg Pathol. 1996;  20 747-753
    CrossrefPubMedGoogle Scholar
  • 17 Tai Y S, Lin P W, Chen S G. et al . Inflammatory pseudotumor of the liver in a patient with human immunodeficiency virus infection.  Hepatogastroenterology. 1998;  45 1760-1763
    PubMedGoogle Scholar
  • 18 Amankonah T D, Strom C B, Vierling J M. et al . Inflammatory pseudotumor of the liver as the first manifestation of Crohns disease.  Am J Gastroenterol. 2001;  96 2520-2522
    CrossrefPubMedGoogle Scholar
  • 19 Takahashi T, Haneda T, Nagano T. et al . Inflammatory pseudotumor of the liver complicated with recurrent gouty arthritis.  Intern Med. 2001;  40 493-498
    PubMedGoogle Scholar
  • 20 Yoon K H, Ha H K, Lee J S. et al . Inflammatory pseudotumor of the liver in patients with recurrent pyogenic cholangitis: CT-histopathologic correlation.  Radiology. 1999;  211 373-379
    PubMedGoogle Scholar
  • 21 Jafri S Z, Bree R L, Agha F P. et al . Inflammatory pseudotumor from sclerosing cholangitis.  J Comput Assist Tomogr. 1983;  7 902-904
    PubMedGoogle Scholar
  • 22 Gough J, Chakrabarti S. Inflammatory pseudotumor of the liver in a patient with chronic sclerosing cholangitis.  Am J Gastroenterol. 1993;  88 1452-1453
    PubMedGoogle Scholar
  • 23 Toda K, Yasuda I, Nishigaki Y. et al . Inflammatory pseudotumor of the liver with primary sclerosing cholangitis.  J Gastroenterol. 2000;  35 304-309
    CrossrefPubMedGoogle Scholar
  • 24 Schwarz R E, Reynolds J C, Lotze M T. ”Pseudo-pseudotumor” of the liver. Adenocarcinoma presenting as an inflammatory pseudotumor.  Dig Dis Sci. 1994;  39 2679-2684
    PubMedGoogle Scholar
  • 25 Hayashi T, Honda H, Kaneko K. et al . Hepatocellular carcinoma with pyrexia: report of a case.  Radiat Med. 1995;  13 133-136
    PubMedGoogle Scholar
  • 26 Ratziu V, Giral P, Charlotte F. et al . Liver fibrosis in overweight patients.  Gastroenterology. 2000;  118 1117-1123
    CrossrefPubMedGoogle Scholar
  • 27 Schmid A, Janig D, Bohuszlavizki A. et al . Inflammatory pseudotumor of the liver presenting as incidentaloma: report of a case and review of the literature.  Hepatogastroenterology. 1996;  43 1009-1014
    PubMedGoogle Scholar
  • 28 Noi I, Loberant N, Cohen I. Inflammatory pseudotumor of the liver.  Clin Imaging. 1994;  18 283-285
    CrossrefPubMedGoogle Scholar
  • 29 Jais P, Berger J F, Vissuzaine C. et al . Regression of inflammatory pseudotumor of the liver under conservative therapy.  Dig Dis Sci. 1995;  40 752-756
    CrossrefPubMedGoogle Scholar
  • 30 Zamir D, Jarchowsky J, Singer C. et al . Inflammatory pseudotumor of the liver - a rare entity and a diagnostic challenge.  Am J Gastroenterol. 1998;  93 1538-1540
    PubMedGoogle Scholar
  • 31 Li G H, Li J Q, Lin Y Z. Inflammatory pseudotumor of the liver.  J Surg Oncol. 1989;  42 244-248
    PubMedGoogle Scholar
  • 32 Mangiante G L, Colombari R, Portuese A. et al . Inflammatory pseudotumor of the liver: case report and review of the literature.  G Chir. 1997;  18 417-420
    PubMedGoogle Scholar

Dr. med. Dr. phil. Erwin Biecker

Medizinische Klinik I, Universitätsklinikum Bonn

Sigmund-Freud-Straße 25

53105 Bonn

Email: Erwin.Biecker1@epost.de

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