title: Hepatic reactive lymphoid hyperplasia in a patient with primary biliary cirrhosis.
abstract: Reactive lymphoid hyperplasia (RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles. Hepatic RLH is known to be associated with gastrointestinal carcinoma and autoimmune diseases including primary biliary cirrhosis (PBC). We report a case of hepatic RLH in a patient with PBC and gastric cancer. A 68 year old Japanese woman with a 10 year history of liver enzyme abnormality was admitted. Laboratory testing revealed that her anti-mitochondrial antibody was markedly elevated. Five mo after the diagnosis of PBC, she was found to have gastric cancer. Abdominal computed tomography disclosed a liver nodule in S8, suggesting metastatic gastric carcinoma. Histopathologically, the resected liver lesion comprised of a nodular proliferation of small lymphocytes with lymphoid follicles. This is the first reported case of hepatic RLH in a patient with both PBC and gastric cancer. Pre-operative diagnosis of hepatic RLH by clinical imaging is extremely difficult. Therefore, a needle biopsy could be useful to make a diagnosis of hepatic RLH, especially to differentiate from metastatic gastrointestinal carcinoma.
authors.affiliation: Mitsuaki Ishida, Fumiyoshi Kojima, Machiko Hotta, Hidetoshi Okabe, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Ishida
authors.forename: Tamio
authors.initials: T
authors.lastname: Nakahara
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsujikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Andoh
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Saito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Kojima
authors.forename: Machiko
authors.initials: M
authors.lastname: Hotta
authors.forename: Tohru
authors.initials: T
authors.lastname: Tani
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Fujiyama
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Okabe