151
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Gorospe L, Fernández-Gil MA, Torres I, Tovar J, García-Miguel P, Tejerina E. Misleading lead: inflammatory pseudotumor of the mediastinum with digital clubbing. Med Pediatr Oncol 2000; 35:484-7. [PMID: 11070481 DOI: 10.1002/1096-911x(20001101)35:5<484::aid-mpo7>3.0.co;2-t] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- L Gorospe
- Department of Radiology, "La Paz" University Hospital, Madrid, Spain.
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152
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Matsubayashi H, Mizoue T, Mizuguchi Y, Shinohara Y, Magami Y, Horibe T, Seki T, Saito T, Serizawa H. A case of hemangioma accompanied by inflammatory pseudotumor of the spleen. J Clin Gastroenterol 2000; 31:258-61. [PMID: 11034012 DOI: 10.1097/00004836-200010000-00018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Both hemangioma and inflammatory pseudotumor (IPT) of the spleen are rare benign mass lesions. Moreover, a splenic hemangioma accompanied by IPT is extremely rare. A 61-year-old woman who suffered from liver cirrhosis had a splenic cavernous hemangioma surrounded by granuloma. The literature on IPT of the spleen has described several possibilities of its causes; however, it is still unknown. This case was accompanied by portal hypertension due to liver cirrhosis, which may cause microrupture of hemangioma resulting in an IPT.
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Affiliation(s)
- H Matsubayashi
- Fourth Department of Internal Medicine, Tokyo Medical University, Japan
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153
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Abstract
INTRODUCTION Inflammatory pseudo-tumors (IPT) are benign neoplasms associated with local or general manifestations. Renal localization seems exceptional, and no case of fever of unknown origin caused by renal inflammatory pseudo-tumors have been reported. EXEGESIS The authors report the case of a man presenting fever of unknown origin and inflammatory syndrome. Computerized tomography showed a renal mass. Nephrectomy was performed, and renal inflammatory pseudo-tumor was diagnosed. After surgical exeresis, the clinical and biological abnormalities vanished. CONCLUSION This rare diagnosis must be considered in these situations. The outcome is excellent.
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Affiliation(s)
- O Epaulard
- Service de médecine interne, pavillon D.-Villars, centre hospitalier universitaire de Grenoble, France
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154
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Gabrielli GB, Casaril M, Stanzial AM, Corrocher R. [Costal osteolytic lesions and multiple hepatic neoformations in a patient with inflammatory pseudotumor]. Ann Ital Med Int 2000; 15:226-31. [PMID: 11059065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Inflammatory pseudotumor is a rare disease, that is regarded as a benign reactive inflammatory process, although its etiology and pathogenesis are still unknown. The liver is one of the organs most frequently involved, but inflammatory pseudotumors have been reported in many other sites in the body. Inflammatory pseudotumor of the liver presents as a solitary or, less frequently, multiple space-occupying lesion, which the common imaging techniques do not clearly distinguish from primitive or metastatic hepatic malignancies. Biopsy of the lesion is therefore necessary for diagnosis. The case of inflammatory pseudotumor described here presented with radiologic features of multiple solid space-occupying lesions in the liver, associated with multiple osteolytic lesions in the ribs. Such an association, very suggestive of malignancy, has not yet been reported for inflammatory pseudotumors. Optimum management of this disease has not yet been standardized. The majority of patients are treated by hepatic resection, although spontaneous regression has also been described. In our case, rapid improvement of both hepatic and costal lesions was observed, although the patient did not receive any specific treatment.
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Affiliation(s)
- G B Gabrielli
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Verona
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155
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Abstract
Wear debris of polyethylene, polymethylmethacrylate, and metal have been recognized to be associated with foreign body reactions, osteolysis, and aseptic prosthetic loosening after joint replacement arthroplasty. Further, foreign body reaction due to the presence of extensive wear debris can cause aggressive granulomatous lesions and pathologic fracture. To our knowledge, there has been no previous report of pathologic fracture of the femur due to an agressive pseudotumor. This report describes a case of pathologic supracondylar fracture of the femur 6 years and 5 months after cementless total knee replacement arthroplasty. The fracture occurred through an aggressive expanding soft tissue mass that was a tumorlike lesion secondary to polyethylene wear debris. The lesion was associated with massive osteolysis around the femoral component of the total knee prosthesis.
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Affiliation(s)
- J Benevenia
- Department of Orthopaedics, New Jersey Medical School, Newark 07013, USA
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156
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Aboulafia DM. Inflammatory pseudotumor causing small bowel obstruction and mimicking lymphoma in a patient with AIDS: clinical improvement after initiation of thalidomide treatment. Clin Infect Dis 2000; 30:826-31. [PMID: 10816156 DOI: 10.1086/313768] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A patient with AIDS was diagnosed with inflammatory pseudotumor with small bowel involvement. After receiving thalidomide treatment, serum tumor necrosis factor (TNF) and soluble TNF receptor II levels normalized, his constitutional and gastrointestinal symptoms diminished, and the mass lesion shrunk.
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Affiliation(s)
- D M Aboulafia
- Division of Hematology/Oncology, Virginia Mason Medical Center, Seattle, WA 98111-0900, USA.
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157
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Kirk VG, McFadden S, Pinto A, Boag G, Sigalet DL. Leiomyoma of the esophagus associated with bronchial obstruction owing to inflammatory pseudotumor in a child. J Pediatr Surg 2000; 35:771-4. [PMID: 10813347 DOI: 10.1053/jpsu.2000.6066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although relatively common in adults, leiomyoma of the esophagus is a rare disorder in children. A single case report describes the coexistence of both esophageal and bronchial leiomyoma in a child. The authors describe the diagnostic and treatment challenges encountered in a 2-year-old boy with coexisting inflammatory pseudotumor and esophageal leiomyoma presenting as massive atelectasis.
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Affiliation(s)
- V G Kirk
- Department of Pediatrics, University of Calgary, Alberta, Canada
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158
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159
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Abstract
Inflammatory pseudotumor (IP) is an uncommon benign tumor during childhood. The most common location is lung, and sporadic cases of IP with extrapulmonary involvement such as liver and abdomen are reported. However, the IP among the reported cases have appeared as solitary masses. A multifocal IP in a 14-year-old girl presumed to result following an Entamoeba histolytica infestation is reported.
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Affiliation(s)
- U Koltuksuz
- Department of Pediatric Surgery, Turgut Ozal Medical Center at the University of Inönü School of Medicine, Malatya, Turkey
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160
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Czauderna P, Sznurkowska K, Korzon M, Roszkiewicz A, Stoba C. Association of inflammatory pseudotumor of the liver and Papillon-Lefevre syndrome--case report. Eur J Pediatr Surg 1999; 9:343-6. [PMID: 10584199 DOI: 10.1055/s-2008-1072279] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A case of hepatic inflammatory pseudotumor mimicking malignancy in a 4-year-old girl with the Papillon-Lefevre syndrome (PLS) is reported. Only recently, an association between this inherited syndrome and liver abscesses has been found. Its possible pathogenesis is discussed and immunologic defects resulting from the Papillon-Lefevre syndrome are presented. The development of inflammatory pseudotumor of the liver might be caused by immunologic disturbances and staphylococcal infection. The picture of the hepatic tumor on imaging in patients with PLS should be attributed rather to inflammatory than neoplastic process.
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Affiliation(s)
- P Czauderna
- Clinic of Pediatric Surgery, Medical University of Gdańsk, Poland
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161
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Abstract
A 5-year-old-boy presented with a right pleural effusion and fever. A tumorous mass was located between the right lung and the liver. The boy underwent a right thoracotomy with excision of the tumor and the adherent parts of the right hemidiaphragm. Histology and immunohistochemistry showed an inflammatory pseudotumor of the diaphragm. This is the first reported case of an inflammatory pseudotumor in this location. A brief review of the heterogeneous theories about the pathogenesis and the different therapeutic regimens for this rare neoplastic entity are discussed.
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Affiliation(s)
- J Höer
- Department of Surgery, Rhenish-Westfalian Technical Highschool, Pauwelsstrasse 30, D-52074 Aachen, Germany
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162
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Querfeld U, Groth W, Eder EF, Hoppe B, Sollberg S. Disseminated cutaneous plasmacellular granuloma associated with membranous glomerulonephritis. Nephrol Dial Transplant 1999; 14:1268-71. [PMID: 10344377 DOI: 10.1093/ndt/14.5.1268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- U Querfeld
- Department of Pediatrics, University of Cologne, Germany
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163
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Yoon KH, Ha HK, Lee JS, Suh JH, Kim MH, Kim PN, Lee MG, Yun KJ, Choi SC, Nah YH, Kim CG, Won JJ, Auh YH. Inflammatory pseudotumor of the liver in patients with recurrent pyogenic cholangitis: CT-histopathologic correlation. Radiology 1999; 211:373-9. [PMID: 10228516 DOI: 10.1148/radiology.211.2.r99ma36373] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To correlate computed tomographic (CT) features of inflammatory pseudotumors of the liver with histopathologic results in patients with recurrent pyogenic cholangitis. MATERIALS AND METHODS CT features of 13 cases of inflammatory hepatic pseudotumor in 10 patients with recurrent pyogenic cholangitis were reviewed. Diagnosis was made by means of surgical resection in all patients. CT scans were analyzed for the appearance of masses and ancillary findings in correlation with the histopathologic findings in each resected specimen. RESULTS The masses were 2.0-7.0 cm (mean, 3.5 cm). At nonenhanced CT, the masses appeared as ill-defined, hypoattenuating lesions. At contrast material-enhanced CT, the masses exhibited central hypoattenuating areas with an iso- or hyperattenuating thickened periphery in four cases and a multiseptate appearance with hyperattenuating internal septa and periphery in nine cases. CT-histopathologic correlation showed that the central hypoattenuating area indicated the presence of chronic inflammatory infiltrates with foamy histiocytes, plasmacytes, and lymphocytes, while iso- or hyperattenuating areas in the periphery and internal septa of the mass represented fibroblastic proliferation. All patients had CT features of recurrent pyogenic cholangitis, such as hepatolithiasis, intrahepatic duct stricture and dilatation, common bile duct calculi, pneumobilia, or parenchymal atrophy. CONCLUSION Although CT features are not specific, inflammatory pseudotumor should be included in the differential diagnosis in patients with recurrent pyogenic cholangitis and a hepatic mass detected at CT.
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Affiliation(s)
- K H Yoon
- Dept of Diagnostic Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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164
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Abstract
A case of inflammatory pseudotumour of the liver is reported, and evidence is presented for its subsequent evolution into malignant non-Hodgkin's lymphoma. Such postulated malignant transformation challenges the assumption that hepatic inflammatory tumours are entirely benign lesions.
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Affiliation(s)
- I Pecorella
- Department of Experimental Medicine and Pathology, University La Sapienza, Roma, Italy
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165
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Affiliation(s)
- A M Rané
- Royal Infirmary, Blackburn, United Kingdom
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166
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Abstract
A case in which inflammatory pseudotumor of the liver (IPTL) seemed to complicate severe congenital neutropenia (Kostmann's disease) is reported. IPTL is a rare entity, especially in childhood. The exact etiology of this lesion is unknown, but it is generally regarded as a benign, reactive inflammatory condition. Based on 15 reported pediatric cases in the literature, the causes, diagnosis, and treatment of IPTL are discussed.
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Affiliation(s)
- C C Hsiao
- Department of Pediatric Hematology and Oncology, Chang Gung Children's Hospital, Kaohsiung, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung, 833, Taiwan, Republic of China
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167
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Nasir A, Budhrani SS, Hafner GH, Sidawy MK, Kaiser HE. Inflammatory pseudotumor of the spleen associated with a cavernous hemangioma diagnosed at intra-operative cytology: report of a case and review of literature. In Vivo 1999; 13:87-92. [PMID: 10218139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
This report presents a case of a 40 year old Caucasian female with a 15 cm inflammatory pseudotumor (IPT) of the spleen with associated areas of splenic hemangioma of the cavernous type. Abdominal CT showed a largely fatty splenic mass with enhancing septations, and scattered calcifications, and a small density in the liver. Grossly, the splenic lesion showed a lobulated cut surface with areas of myxoid change, necrosis, hemorrhage and cystic softening. The diagnosis of IPT was suggested at intraoperative consultation using cytologic smears and was, subsequently confirmed on permanent sections. Histologically, the lesion consisted of a densely collagenized spindle cell stroma with patchy aggregates of lymphocytes and plasma cells, and scattered foci showing hemosiderin-laden macrophages extracellular calcium deposits and osseous metaplasia. The stromal spindle cells were immuoreactive for smooth muscle actin and vimentin confirming their myofibroblastic phenotype. There were extensive areas of infarction within the mass. The patient, however, remained asymptomatic preoperatively. Histologic analysis in this case raises the possibility that low grade, perhaps repetitive, trauma to the hemangioma may have resulted in intralesional hemorrhages which, through a process of organization, may have evolved into this sizable inflammatory pseudotumor. In addition, this report reviews the current literature on the clinical significance and presentation, morphologic and immunohistochemical findings, prognosis, differential diagnosis, pathogenesis and therapy of the splenic IPT.
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Affiliation(s)
- A Nasir
- Department of Pathology, George Washington University, School of Medicine and Health Sciences, Washington DC 20037, USA
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168
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Abstract
The clinical features of inflammatory pseudotumour of lymph nodes, a distinct non-malignant histopathological entity firstly described in 1988, are summarized based upon a detailed analysis of 4 personal cases and 47 cases reported in the literature. The mean age of the patients is 38 years (range 8 to 82 years) and there is no gender predilection. One third present with asymptomatic lymphadenopathy and 47% present with fever, nearly all meeting the criteria of fever of unknown origin. Abdominal complaints are occasionally present. Intermittence of symptoms is common. Hepatosplenomegaly is unusual. All lymph node areas may be involved but abnormalities are mostly confined to one or two anatomic regions. No extranodal involvement has been reported although inflammatory pseudotumour may occur in several organs with similar morphological features and identical signs of inflammations. Routine blood tests are normal except for signs of inflammation. The lesions are Gallium-avid. Diagnosis is based upon typical histopathological features. The prognosis is favorable and surgical resection frequently leads to cure. Spontaneous resolution of symptoms has been reported and nonsteroidal anti-inflammatory drugs may suppress the clinical manifestations.
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Affiliation(s)
- D C Knockaert
- Department of General Internal Medicine, University Hospital Gasthuisberg, K.U. Leuven, Belgium
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169
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Abstract
The authors report an unusual presentation of inflammatory pseudotumor (IPT) that caused intestinal obstruction in a 9-year-old boy, and discuss the clinicopathologic features of this rare entity with emphasis on diagnosis and treatment. There are no specific presumptive clinical and laboratory findings, including tumor markers and imaging techniques, that distinguish mesenteric IPT from other abdominal mass lesions. The most important diagnostic aid is to bear this entity in mind when a child presents with intestinal obstruction associated with an abdominal mass. Radical unnecessary surgical procedures or potentially harmful therapy should be avoided, and appropriate treatment is achieved by total excision of the lesion in most of the cases.
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Affiliation(s)
- A O Ciftci
- Department of Pediatric Surgery, Hacettepe University Medical Faculty, Ankara, Turkey
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170
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Abstract
A 59-year-old woman who had received cobalt-60 (60Co) interstitial radiation therapy (total 44 Gy) in the right bucco-gingival region for inflammatory pseudotumour was found to have metachronous double malignant neoplasms. Initial osteosarcoma of the right mandibular angle and subsequent squamous cell carcinoma of the right buccal mucosa were identified 28 and 33 years after the radiation, respectively. Since both tumours were located very close to the focus of previous radiation, the therapy was considered to be responsible for their genesis. The patient had systemic metastases of the osteosarcoma.
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MESH Headings
- Adult
- Carcinoma, Squamous Cell/diagnostic imaging
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Cobalt Radioisotopes/adverse effects
- Cobalt Radioisotopes/therapeutic use
- Female
- Granuloma, Plasma Cell/complications
- Granuloma, Plasma Cell/pathology
- Granuloma, Plasma Cell/radiotherapy
- Humans
- Mandibular Neoplasms/diagnostic imaging
- Mandibular Neoplasms/etiology
- Mandibular Neoplasms/pathology
- Mouth Diseases/complications
- Mouth Diseases/pathology
- Mouth Diseases/radiotherapy
- Mouth Mucosa/diagnostic imaging
- Mouth Mucosa/radiation effects
- Mouth Neoplasms/diagnostic imaging
- Mouth Neoplasms/etiology
- Mouth Neoplasms/pathology
- Neoplasms, Radiation-Induced/diagnostic imaging
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Second Primary/diagnostic imaging
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/pathology
- Osteosarcoma/diagnostic imaging
- Osteosarcoma/etiology
- Osteosarcoma/pathology
- Tomography, X-Ray Computed
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Affiliation(s)
- K Onodera
- Department of Oral Pathology, Tohoku University School of Dentistry, Sendai, Miyagi, Japan.
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171
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Pimenta AP, Lopes JM, Gouveia A. Esophageal inflammatory pseudotumor associated with a pseudodiverticulosis cyst: two inter-related lesions? Dis Esophagus 1998; 11:272-5. [PMID: 10071813 DOI: 10.1093/dote/11.4.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
There are some unusual esophageal lesions, which by their rarity, and location or etiology raise difficult therapeutic decisions for surgeons. In this report, we describe an esophageal inflammatory pseudotumor (IPT) associated with a pseudodiverticulosis cyst in an adult male. We discuss the pathogenic and the anatomopathological aspects of these uncommon associated lesions as well as the treatment of ITP.
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Affiliation(s)
- A P Pimenta
- Surgery 4, Medical Faculty of Porto, Hospital S. João, Portugal
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172
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Affiliation(s)
- T H Young
- Department of Internal Medicine, Tri-Service General Hospital, and the National Defense Medical Center, Taipei, Taiwan, Republic of China
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173
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Tai YS, Lin PW, Chen SG, Chang KC. Inflammatory pseudotumor of the liver in a patient with human immunodeficiency virus infection. Hepatogastroenterology 1998; 45:1760-3. [PMID: 9840142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A 31 year-old male was admitted for investigation of a hepatic tumor, which was incidentally found during abdominal sonography. Abdominal ultrasound revealed a large heterogeneous hyperechoic mass, 4x6x5cm in size, located at the inferior portion of the medial segment of the liver. Abdominal computed tomography without enhancement showed a hepatic tumor, 6 cm in size, in the medial segment of the liver. Malignancy was suspected in the light of radiological presentation. Therefore, wedge resection of the hepatic tumor was performed. The pathological findings revealed that the hepatic tumor was composed of dense fibrous tissue, plump spindle cells, foamy histiocytes, abundant lymphocytes, plasma cells and macrophages which led to the diagnosis of inflammatory tumor of the liver. The post-operative course was uneventful, and the patient was discharged two weeks after operation. Unfortunately, high fever and persisting headache were noted one week after discharge, thus the patient was re-admitted. The infectious focus was investigated during the second admission. Serological test for anti-human immunodeficiency virus was positive. Computed tomography of the brain revealed inflammatory changes over the territory of right middle cerebral artery. The patient died two weeks after the onset of encephalitis. We believe this to be the first case of inflammatory pseudotumor of the liver associated with human immunodeficiency virus infection.
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Affiliation(s)
- Y S Tai
- Department of Surgery, Medical College, National Cheng Kung University, Tainan, Taiwan ROC
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174
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Dettmeyer R, Varchmin-Schultheiss K, Madea B. Sudden death of an 18-year-old man with homocystinuria and intracranial inflammatory pseudotumor (IPT). Forensic Sci Int 1998; 94:19-24. [PMID: 9670479 DOI: 10.1016/s0379-0738(98)00054-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
An 18-year-old mentally deficient man with well-known homocystinuria died suddenly within a few minutes. He had a history of severe oligophrenia, bilateral ectopia lentis requiring extraction of both lenses and operatively corrected genu valgum on both sides. In 1993 a hypergammaglobulinemia was noticed and a decortication on the left side after purulent pneumonia became necessary. Four months before death multiple abscesses in the spleen and pancreas lead to splenectomy and resection of the pancreatic tail. Furthermore, an isolated inflammatory pseudotumor (IPT) of the brain was found. Autopsy revealed as cause of death a pulmonary embolism. The pathogenesis of the cause of death and concomitant diseases will be discussed.
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Affiliation(s)
- R Dettmeyer
- Institute of Forensic Medicine, University of Bonn, Germany
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175
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Williams ME, Longmaid HE, Trey G, Federman M, Crosson AW. Renal failure resulting from infiltration by inflammatory myofibroblastic tumor responsive to corticosteroid therapy. Am J Kidney Dis 1998; 31:E5. [PMID: 10074585 DOI: 10.1053/ajkd.1998.v31.pm10074585] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare disease of inflammatory and spindle cell proliferative lesions in multiple sites. Most frequently reported in the lungs, a variety of extrapulmonary sites have been described. We report the first case of IMT causing renal failure by massive bilateral renal infiltration. Renal function continued to deteriorate (peak serum creatinine level, 8.4 mg/dL) despite placement of a ureteral stent. The kidneys were diffusely enlarged on computed tomographic (CT) scan. Renal biopsy showed myofibroblastic proliferation and inflammatory infiltration. Renal failure responded favorably over weeks to corticosteroid therapy (serum creatinine level, 2.8 mg/dL) with a marked reduction in bilateral renal enlargement by CT scan.
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Affiliation(s)
- M E Williams
- Renal Unit, Joslin Diabetes Center, 1 Joslin Pl, Boston, MA 02215, USA.
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176
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Tajima K, Kosugi S, Fuyama S, Maeda K, Hayashi T, Yahagi A, Akiba J, Suzuki K, Satoh S, Sasaki H. Multiple inflammatory pseudotumors of the liver associated with acute myeloblastic leukemia. Intern Med 1998; 37:542-5. [PMID: 9678690 DOI: 10.2169/internalmedicine.37.542] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 26-year-old man, diagnosed with acute myelogenous leukemia had multiple inflammatory pseudotumors (IPT) in the liver. The patient presented complete remission after remission induction therapy, and then showed right upper quadrant discomfort and intermittent fever. An ultrasonography disclosed multiple hypoechoic nodules in the liver. A biopsy of the nodules showed focal liver cell necrosis with scant inflammatory cells, compatible with IPT. After several courses of chemotherapy, the nodules in the liver increased. The second liver biopsy of the nodule showed fibrosis. Multiple IPTs in the liver should be distinguished from abscess and metastatic nodules.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy, Needle
- Cytarabine/administration & dosage
- Cytarabine/analogs & derivatives
- Daunorubicin/administration & dosage
- Diagnosis, Differential
- Granuloma, Plasma Cell/complications
- Granuloma, Plasma Cell/diagnosis
- Granuloma, Plasma Cell/pathology
- Humans
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/drug therapy
- Liver Abscess/diagnosis
- Liver Diseases/complications
- Liver Diseases/diagnosis
- Liver Diseases/pathology
- Liver Neoplasms/diagnosis
- Liver Neoplasms/secondary
- Magnetic Resonance Imaging
- Male
- Mercaptopurine/administration & dosage
- Prednisolone/administration & dosage
- Tomography, X-Ray Computed
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Affiliation(s)
- K Tajima
- Third Department of Internal Medicine, Yamagata University School of Medicine
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177
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Ohno M, Nakamura T, Ohbayashi C, Tabuchi Y, Nogi Y, Saitoh Y. Colonic obstruction induced by plasma cell granuloma of the transverse colon: report of a case. Surg Today 1998; 28:416-9. [PMID: 9590709 DOI: 10.1007/s005950050153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Plasma cell granuloma is mainly composed of reactive plasma cell proliferation, the origin of which is uncertain. Immunohistochemically, the plasma cells are characterized by a polyclonal nature, and must be distinguished from plasmacytoma which displays a monoclonal nature. This tumor is most commonly found in the lung and bronchus, but has rarely been described in the alimentary tract. We report herein a case of plasma cell granuloma of the transverse colon. A 71-year-old woman was admitted for lower abdominal pain with severe inflammation and anemia. Ultrasound examination and computed tomography showed an abdominal tumor. Barium enema revealed the tumor to be located in the transverse colon causing colonic obstruction. The resected tumor was spherical and mainly spread in the submucosal layer. Microscopically, the tumor consisted of severe infiltration of mature plasma cells within the spindle-shaped myofibroblasts. Immunohistochemical studies showed IgA, IgG, IgM, and kappa and lambda chains, and revealed a polyclonal nature of the plasma cells. Thus, a pathological diagnosis of plasma cell granuloma affecting the transverse colon was made. To the best of our knowledge, this is the first report of successful surgical resection of plasma cell granuloma of the colon.
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Affiliation(s)
- M Ohno
- First Department of Surgery, Kobe University School of Medicine, Japan
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178
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Abstract
A rare case of plasma cell granuloma (PCG) of the brain is reported. An 18-year-old man with a well known homocystinuria and a history of severe oligophrenia, grand-mal-epilepsia, bilateral ectopia lentis requiring extraction of both lens and operatively correlated genu valgum, died suddenly within a few minutes. In 1993 a hypergammaglobulinemia was noticed and a decortication on the left side after purulent pneumonia became necessary. Four months before death, multiple abscesses in the spleen and pancreas led to splenectomy and resection of the pancreatic tail. Autopsy revealed a pulmonary embolism and an isolated intracranial plasma cell granuloma of the left hemisphere.
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Affiliation(s)
- R Dettmeyer
- Department of Forensic Medicine, University of Bonn, Germany
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179
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Skyba VV, Slushyns'kyĭ MS, Kosiuk MN. [A case of duodenal ileus, caused by pseudotumor]. KLINICHNA KHIRURHIIA 1998:102-3. [PMID: 9518079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- V V Skyba
- Kafedra fakul'tets'koï khirurhiï Ukraïns'koï akademiï narodnoï medytsyny, m. Kyïv
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180
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Abstract
We report a rare case of multiple gastric plasmacytomatous lesions at an early stage found incidentally in a stomach resected because of gastric cancer. The three lesions had different macroscopic features, showing depressed, submucosal, and nodular tumor-forming types. The smallest, a depressed lesion, produced IgG of the lambda and kappa types, and had a plasma-cell granuloma-like appearence, whereas the largest, a submucosal tumor, was formed by the monoclonal proliferation of atypical plasma cells containing IgA-kappa type immunoglobulin, and the nodular lesion exhibited histological features intermediate between those of the other two lesions. From their microscopic features and the profile of immunoglobulin production, we believe that these lesions may represent different stages in the possible course of development of plasmacytoma from the early stage of plasma cell granuloma. All three lesions were located far from the gastric carcinoma and it was unclear whether they had any causal relationship with it.
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Affiliation(s)
- Y Kitayama
- First Department of Pathology, Hamamatsu University School of Medicine, Japan
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181
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Aragón Sánchez J, García Molina F, González Ruiz M, Franco Ossorio JD, Ortegón Castellano B, Ruiz Campos J, Moreno del Cubillo L, Medina Díez J. [Cecal plasma-cell granuloma as a cause of ileocolic intussusception]. Rev Esp Enferm Dig 1997; 89:727-8. [PMID: 9445547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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182
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183
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Sakalkale RP, Kapur VK, Bhagwat AD. Retrobulbar pseudotumor as a manifestation of Staphylococcal pyemia. Indian Pediatr 1997; 34:441-3. [PMID: 9332122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- R P Sakalkale
- Dept. of Pediatric Surgery, B.J. Wadia Hospital for Children, Parel, Mumbai
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184
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Dweik RA, Goldfarb J, Alexander F, Stillwell PC. Actinomycosis and plasma cell granuloma, coincidence or coexistence: patient report and review of the literature. Clin Pediatr (Phila) 1997; 36:229-33. [PMID: 9114995 DOI: 10.1177/000992289703600408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- R A Dweik
- Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, OH 44195, USA
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185
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De Monti M, Ghilardi G, Cavenati S, Reale D, Pezzica E, Scorza R. [Plasma-cell granuloma of the sigmoid colon concomitant with adenocarcinoma of the cecum. Viewpoint for debate, literature review on pseudotumors, idiopathic colitis and cancer]. Ann Ital Chir 1997; 68:245-51. [PMID: 9290018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A case of colonic pseudotumor, causing intestinal occlusion, concomitant with a caecum neoplasia is reported. A male 69 years old was referred to our Institution for colic abdominal pain: colonoscopy aborted because of an insuperable sigma stenosis; diagnostic enema confirmed the sigmoid stenosis, originally advised as neoplastic. As operation, the sigmoid tumor appeared accompanied with enlarged draining lymph nodes and peritoneal sac was disseminated of miliary-like whity granules. Hystological examination showed a plasma-cell granuloma with nodular and peritoneal chronic inflammatory reaction. A pancolonoscopy, performed fourty days later, discovered an unsuspected adenocarcinoma neoplasia of the caecum, that was resected with a second operation. Regional nodes were not involved. The authors make a review of international literature about of plasma-cell granuloma, pseudotumor and inflammatory chronic bowel diseases in order to identify possible correlations between pseudotumor and neoplasms. The extremely low incidence of plasma-cell granulomas in the alimentary tract (17 case since 1970 to 1994) and the reported association with concomitant neoplasms (29%) suggest to consider extremely useful an accurate study of patients with intestinal pseudotumors in order to identify neoplasms of the gastrointestinal tract as well as of other organs.
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Affiliation(s)
- M De Monti
- Università degli Studi di Milano, Cattedra di Chirurgia Generale
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186
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Abstract
Primary pulmonary tumours are rare in the paediatric population. Of the benign tumours, the most common is the inflammatory pseudotumour (plasma cell granuloma). It can present as a variety of non-specific symptoms which may delay diagnosis. It usually occupies a peripheral pulmonary location and gives rise to symptoms due to its local mass effect and destructive invasion. We report the case of an endobronchial inflammatory pseudotumour presenting as an exacerbation of asthma in a 10-year-old girl. Appropriate investigation lead to pre-operative diagnosis and early complete surgical resection. A good prognosis is anticipated.
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Affiliation(s)
- D Jayne
- Department of General Surgery, Burnley General Hospital, UK
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187
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Chiang IP, Wang J, Tsang YM, Hsiao CH. Focal myositis of esophagus: a distinct inflammatory pseudotumor mimicking esophageal malignancy. Am J Gastroenterol 1997; 92:174-5. [PMID: 8995969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- I P Chiang
- Department of Pathology, National Taiwan University Hospital, Taipei
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188
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Han CP, Chen KF, Chen KH, Tyan YS, Chen SS, Ger GC, Jeng SY. Pelvic inflammatory pseudotumor with central infectious abscess: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 1996; 58:374-9. [PMID: 9037856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Inflammatory pseudotumors (IPT) are a fascinating group of lesions which involve almost all organs and tissues of the body. The clinical manifestations are diverse. Final diagnosis can only be made by meticulous microscopic examination of different areas of the tumor. A 60 year-old woman had a pelvic IPT with central infectious abscess. The lesion involved her urinary bladder, mesentery, terminal ileum, right rudimentary ovary and the abdominal wall. It mimicked malignant tumor clinically, and led to total surgical excision. Early follow-up has shown a favorable results. IPTs are extremely uncommon. The characteristic pathologic picture is a reparative fibroblastic tissue infiltrated by polymorphic inflammatory cells. Pelvic IPT, admixed with central infectious abscess, is even rarer. Prior pelvic surgery and pasteurella hemolytica infection might be causative factors in this reported case.
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Affiliation(s)
- C P Han
- Department of Obstetrics and Gynecology, Military General Hospital, Taichung, Taiwan, R.O.C
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189
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Abstract
The rapid growth of an inflammatory pseudotumor in the right atrium of an infant with pulmonary valve stenosis and atrial septal defect is documented. Systemic manifestations, including fever, weight loss, leukocytosis, and hypergammaglobulinemia, suggested infection; the diagnosis was made after surgical resection. Sixteen months after surgery the infant is asymptomatic, and the hypergammaglobulinemia and leukocytosis have resolved. Trauma may have been the inciting factor for this inflammatory pseudotumor.
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Affiliation(s)
- P C Jenkins
- Department of Pediatrics, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon NH 03766, USA
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190
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Konishi H, Ookuma H, Hara H, Okayasu H, Wakayama Y, Saiki S. [A case of plasma cell granuloma associated with cerebral infarction]. Rinsho Shinkeigaku 1996; 36:854-7. [PMID: 8952352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 36-year-old male complained of double-vision and pain of left orbita. On admission, T1-weighted Gd-enhanced MR image of his head showed high intensity lesion in the left carvenous sinus, and his chest X-P showed multiple coin lesions. Microscopic findings of lung open biopsy specimen showed prolifelation of mature plasma cell in the granuloma and the patient was diagnosed as having plasma cell granuloma. Although the lung lesions had a tendency to spontaneous remission, we started the steroid pulse therapy and betamethasone (8 mg/day) therapy for intracranial lesion. Then the lung lesions vanished and we decreased the dose of betamethasone from 8 mg/day to 6 mg/day. As the results, the intracranial lesion of this patient expanded and left middle cerebral artery occluded, resulting in right hemiparesis and total aphasia. This is the first case report of plasma cell granuloma with a lesion in the central nervous system associated with cerebral infarction.
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Affiliation(s)
- H Konishi
- Department of Medicine, Showa University, Fujigaoka Hospital
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191
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Sfairi A, Farah A, Patel JC. [Inflammatory pseudotumor of the small intestine: un unusual cause of intestinal intussusception in adults]. Presse Med 1995; 24:1909. [PMID: 8745543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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192
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Wiseman JB, Arriaga MA, Houston GD, Boyd EM. Facial Paralysis and Inflammatory Pseudotumor of the Facial Nerve in a Child. Otolaryngol Head Neck Surg 1995; 113:826-8. [PMID: 7501405 DOI: 10.1016/s0194-59989570033-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- J B Wiseman
- Department of Otolaryngology/Head and Neck Surgery, Wilford Hall Medical Center, USAF
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193
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Foschini MP, Scarpellini F, Rinaldi P, Mancini AF, Accinelli G, Eusebi V. [Inflammatory pseudotumor of the urinary bladder. Study of 4 cases and review of the literature]. Pathologica 1995; 87:653-8. [PMID: 8927426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Inflammatory pseudotumour (IPT) of the urinary bladder is a benign proliferative lesion which can simulate clinically and histologically a sarcoma. Aim of this study is to report four new cases and to review the literature. CASES Two patients were male, aged 2 and 4 years respectively (cases 1 and 2); cases 3 was a 26 year old woman and case 4 was a 40 year old man. Three patients presented with gross haematuria. One patient (case 4) presented with abdominal pain. On cystoscopy all the lesions presented as polypoid masses, ranging from 0.5 to 3 cm. in greatest axis. All patients were treated with conservative surgery. Case 1 died of unrelated causes 7 years later; at autopsy no evidence of residual bladder lesion was found. All the remaining three patients are alive and free of disease 8, 4, and 3 years respectively. RESULTS On histology all the lesions had similar features. They were characterized by a submucosal growth of spindle cells with little pleomorphism, immersed in abundant myxoid stroma. In all cases immunoreactivity with vimentin was obtained; smooth muscle actin was focally positive in two cases and cytokeratin in one case. Bladder muscular wall was involved in three cases. CONCLUSION The present four cases showed same histological and immunohistochemical feature of the IPTs previously described in the literature. IPT of the urinary bladder must be differentiated from malignant lesions such as rhabdomyosarcoma, leiomyosarcoma, inflammatory fibrosarcoma, sarcomatoid carcinoma. Differential diagnosis is based mainly on the characteristic histological picture of IPT. Immunohistochemistry can be misleading as IPT shares in common with those malignant conditions, positivity with some markers, such as desmin with rhabdomyosarcoma and cytokeratin with sarcomatoid carcinoma.
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Affiliation(s)
- M P Foschini
- Istituto di Anatomia ed istologia Patologica, Università di Bologna
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195
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Abstract
A 47-year-old female presented with complaints of epigastric pain, poor appetite, and dysphagia. Abdominal CT and esophagogastroduodenoscopy revealed a 9-cm mass extrinsic to the distal esophagus. Esophagogastrectomy was performed. The distal esophagus contained multiple foci of heterotopic pancreatic tissue. There was associated inflammation and fat necrosis in the surrounding periesophageal soft tissue. Heterotopic pancreas is uncommon in the esophagus, with only a few reports appearing in the English literature. The clinical features of heterotopic pancreas, and the pathophysiology of the associated inflammatory lesion is discussed.
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Affiliation(s)
- A E Noffsinger
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Ohio 45267-0529, USA
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196
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Gullotta F. Critical commentary to "coexistence of plasma cell granulomas of lung and central nervous system". Pathol Res Pract 1995; 191:1046. [PMID: 8838376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- F Gullotta
- Institut für Neuropathologie der Universität, Münster, Germany
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197
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Le Marc'hadour F, Lavieille JP, Guilcher C, Brambilla E, Brichon PY, Lebas JF, Charachon R, Pasquier B. Coexistence of plasma cell granulomas of lung and central nervous system. Pathol Res Pract 1995; 191:1038-45. [PMID: 8838375 DOI: 10.1016/s0344-0338(11)80606-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A rare case of concurrent plasma cell granulomas (PCG) of the lung and the central nervous system (CNS) is reported. A 30-year-old man was presented with recurrent left headaches lasting for two years. Computerized tomographic (CT) scan and magnetic resonance imaging (MRI) of the head disclosed a process extending from the lateral aspect of the left cavernous sinus to the tentorium cerebelli and the infratemporal fossa through the foramen ovale. At the same time, chest-X ray and CT scan showed three symptomless masses of the pulmonary right lower lobe. Histological examination of cerebral samples and of one of the pulmonary nodules revealed the presence of a fibrous tissue containing numerous lymphocytes and plasma cells as well as remnants of vascular and respiratory structures. Immunohistochemical study proved these cells to be polyclonal. Ultrastructural analysis confirmed the presence of lymphoid cells and failed to disclose any argument for meningioma or histiocytosis X. The differential diagnostic problems of PCG are discussed as well as considerations about clinicopathological features, histogenesis and pathogenesis of inflammatory pseudotumours (IPT).
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Affiliation(s)
- F Le Marc'hadour
- Department of Pathology, University of Medicine, Grenoble, France
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198
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Müller KM, Theile A. Critical commentary to "'coexistence of plasma cell granulomas of lung and central nervous systems". Pathol Res Pract 1995; 191:1047-8. [PMID: 8838377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- K M Müller
- Institut für Pathologie, Bergmannsheil, Bochum, Germany
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199
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Abstract
A unique case of plasma cell granuloma of the larynx associated with sudden death in a young HIV-positive woman is described. The plasma cell infiltration fulfilled the criteria for plasma cell granuloma, showing characteristic histologic and immunohistochemical features (polyclonality). A review of the most recent literature is provided.
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Affiliation(s)
- C A Fonseca
- Medical Examiner Office, Philadelphia, Pennsylvania, USA
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200
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Akiyama T, Saito H, Kiriyama M, Tomita F, Kosaka T, Kita I, Takashima S, Matsunou H. A case of gallbladder cancer associated with a common bile duct neuroma, and a cystic lesion of the liver with histologic findings similar to those of an inflammatory pseudotumor. J Gastroenterol 1995; 30:408-12. [PMID: 7647910 DOI: 10.1007/bf02347520] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report a rare case of gallbladder cancer associated with a common bile duct neuroma, and a cystic liver lesion with histologic findings similar to an inflammatory pseudotumor, in a patient who had had no previous abdominal surgery. The patient was a 62-year-old man whose major complaint was fever. Ultrasonography and a computed tomography scan revealed gallstones, an elevated lesion in the gallbladder, and a cystic liver lesion. Endoscopic retrograde cholangiopancreatography demonstrated stenosis of the common bile duct. Cultures of the cystic fluid and gallbladder bile were positive for Staphylococcus aureus. The patient underwent hepatectomy (inferior S4, S5, and S6), cholecystectomy, resection of the common bile duct, and right hemicolectomy. The resected specimens revealed gallbladder cancer with the microscopic appearance of a papillary adenocarcinoma, and a 12 x 4.5 x 3.5 cm cystic liver lesion with a wall 7 mm thick. Histologic studies of the wall of the cystic liver lesion revealed infiltration by histiocytes and plasma cells, and the presence of fibrous connective tissue, which findings are characteristic of inflammatory pseudotumors. A 9 x 6 mm elevated lesion, with the microscopic appearance of a neuroma, was resected from the common bile duct.
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MESH Headings
- Adenocarcinoma, Papillary/complications
- Adenocarcinoma, Papillary/diagnosis
- Adenocarcinoma, Papillary/secondary
- Adenocarcinoma, Papillary/surgery
- Bile Duct Neoplasms/complications
- Bile Duct Neoplasms/diagnosis
- Bile Duct Neoplasms/surgery
- Cholecystectomy
- Cholelithiasis/complications
- Cholelithiasis/diagnosis
- Cholelithiasis/surgery
- Diagnosis, Differential
- Endoscopy, Digestive System
- Gallbladder Neoplasms/complications
- Gallbladder Neoplasms/diagnosis
- Gallbladder Neoplasms/pathology
- Gallbladder Neoplasms/surgery
- Granuloma, Plasma Cell/complications
- Granuloma, Plasma Cell/diagnosis
- Granuloma, Plasma Cell/surgery
- Hepatectomy
- Humans
- Liver Diseases/complications
- Liver Diseases/diagnosis
- Liver Diseases/surgery
- Liver Neoplasms/complications
- Liver Neoplasms/diagnosis
- Liver Neoplasms/secondary
- Liver Neoplasms/surgery
- Male
- Middle Aged
- Neuroma/complications
- Neuroma/diagnosis
- Neuroma/surgery
- Tomography, X-Ray Computed
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Affiliation(s)
- T Akiyama
- Second Department of Surgery, Kanazawa Medical University, Ishikawa, Japan
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