Pseudolymphoma of the liver associated with primary biliary cirrhosis: a case report and review of literature.
We report a case of two pseudolymphomas of the liver in a 63-year-old Japanese woman with primary biliary cirrhosis. One of the lesions was found incidentally during a medical examination, presenting as a 10 mm hypodense nodule that revealed hyperdensity in the early phase and hypodensity in the late phase in computed tomography (CT) after injection of contrast medium. Retrospectively, the 10 mm nodule had first been discovered as a 4 mm nodule during CT 4 years previously. Superparamagnetic iron oxide-enhanced MRI revealed another 4 mm hyperintense nodule in segment 6 in addition to the 10 mm hyperintense nodule in segment 7. CT during arterial portography revealed two hypointense nodules. Findings with other imaging modalities such as ultrasonography, magnetic resonance imaging, and hepatic angiography were consistent with hepatocellular carcinoma. A right posterior segmentectomy was performed, and the lesions were microscopically diagnosed as pseudolymphoma. To the best of our knowledge, only 31 other cases of this disease have ever been reported, with a highly asymmetrical male:female ratio of 1:9.7. Although we could find only one case of transformation of hepatic pseudolymphoma into lymphoma in the liver, the exact nature of development from benign pseudolymphoma to malignant lymphoma is still not fully understood and cases of hepatic lymphoma need to be followed carefully.
Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan. okada351116@yahoo.co.jp
Toshihide
T
Okada
Hiroshi
H
Mibayashi
Kenkei
K
Hasatani
Yoshiaki
Y
Hayashi
Shigetsugu
S
Tsuji
Yoshibumi
Y
Kaneko
Masashi
M
Yoshimitsu
Takashi
T
Tani
Yoh
Y
Zen
Masakazu
M
Yamagishi
D018951:Antigens, CD20 / Q000378:metabolism; D001402:B-Lymphocytes / Q000378:metabolism; D017252:CD3 Complex / Q000378:metabolism; D005260:Female; D006801:Humans; D007564:Japan; D008099:Liver / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000150:complications*; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019310:Pseudolymphoma / Q000175:diagnosis* / Q000209:etiology; D013601:T-Lymphocytes / Q000378:metabolism; D014057:Tomography, X-Ray Computed
D018951:Antigens, CD20; D017252:CD3 Complex