title: Diagnosis of inflammatory pseudotumor of the liver.
abstract: Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown origin, it has the appearance of a malignant tumor but has a benign histology and clinical course. Therefore, we studied five patients with IPT of the liver to determine what examination can aid in its diagnosis. Five cases of inflammatory pseudotumor of the liver were analyzed. All patients were examined by echography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERC) and angiography to diagnose the liver tumor. In all patients echography and CT scan showed a similar appearance while MRI showed a variable pattern. In two patients ERC showed a stenotic image of intra-hepatic bile ducts. In the angiographic study, the arterial phase in three patients showed a hypervascular tumor and in one patient, a hypovascular tumor. Vascular abnormality was presented in one patient. Similarly, portography in four patients showed some abnormality. We performed ultrasonography-guided percutaneous needle biopsy in two patients in order to diagnose IPT. Histological examinations of two patients were consistent with IPT. The other three patients underwent surgical treatment for a cholangiocellular carcinoma or abscess. It is difficult to diagnose IPT of the liver exclusively with an image examination. Ultrasonography-guided percutaneous liver biopsy should be performed in order to diagnose IPT by histology.
authors.affiliation: First Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sakai
authors.forename: Katsuya
authors.initials: K
authors.lastname: Shiraki
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kawakita
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ohmori
authors.forename: Iori
authors.initials: I
authors.lastname: Itoh
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakano
authors.forename: Masayo
authors.initials: M
authors.lastname: Yasuda
authors.forename: Koichirou
authors.initials: K
authors.lastname: Yamakado
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yagi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamagiwa
authors.forename: Hajime
authors.initials: H
authors.lastname: Yokoi
authors.forename: Takashi
authors.initials: T
authors.lastname: Noguchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000368:Aged; D000792:Angiography; D005260:Female; D006104:Granuloma, Plasma Cell / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000276:immunology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed