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Pseudolymphoma of the liver: a case report and literature review

View Article: PubMed Central

ABSTRACT

Pseudolymphoma is a benign lymphocytic tumor-like lesion, and its occurrence in the liver is rare. Here, we report the case of a 78-year-old woman with pseudolymphoma of the liver. She had a history of tremors for several years. Therefore, she underwent computed tomography (CT) for screening, and liver tumors were incidentally identified. She did not have any history of liver disease. Liver function test results and tumor marker levels were all within normal limits, and viral markers for hepatitis were negative. Contrast-enhanced CT revealed four nodules measuring up to 13 mm in diameter with ring enhancement in both lobes of the liver. On magnetic resonance imaging, the lesions showed slightly high intensity on T2-weighted images and high intensity on diffusion-weighted images. Because of atypical imaging findings, the tumors could not be definitively diagnosed. Therefore, we performed laparoscopic limited resection of segments 2, 3, 4, and 8 of the liver. The final pathological diagnosis was pseudolymphoma of the liver. The patient has had no signs of recurrence for 6 months after the surgery. Although pseudolymphoma of the liver is rare, it is necessary to consider it in the differential diagnosis of a liver tumor.

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Magnetic resonance imaging (MRI) showing a nodule with slight high intensity on a T2-weighted image and high intensity on a diffusion-weighted image. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced dynamic MRI showing a nodule with defects in the hepatocyte phase in segments 2, 3 (arrow), 4, and 8 of the liver
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Fig2: Magnetic resonance imaging (MRI) showing a nodule with slight high intensity on a T2-weighted image and high intensity on a diffusion-weighted image. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced dynamic MRI showing a nodule with defects in the hepatocyte phase in segments 2, 3 (arrow), 4, and 8 of the liver

Mentions: Imaging revealed four nodules measuring up to 13 mm in diameter in segments 2, 3, 4, and 8 of the liver. Ultrasonography revealed low echoic lesions in segments 2 (13 mm in diameter) and 3 (8 mm in diameter) of the liver. On contrast-enhanced ultrasonography using perflubutane, these lesions showed enhancement in the arterial phase, subsequent washout in the portal phase, and defects in the Kupffer phase. On contrast-enhanced CT, these nodules showed ring enhancement in the arterial phase and subsequent washout in the portal phase. In addition, small nodules with the same enhancement pattern were identified in segments 4 and 8 (Fig. 1). CT arterial portography revealed nodular perfusion defects, and CT hepatic arteriography revealed strong enhancement in the early phase and ring enhancement in the late phase. Magnetic resonance imaging (MRI) showed low intensity on T1 weighted images, slightly high intensity on T2 weighted images, and high intensity on diffusion-weighted images. On gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced dynamic MRI, the nodules showed ring enhancement in the arterial phase and defects in the hepatocyte phase (Fig. 2). The patient also underwent whole-body positron emission tomography-computed tomography, and all lesions had standardized uptake values up to 4.6.Fig. 1


Pseudolymphoma of the liver: a case report and literature review
Magnetic resonance imaging (MRI) showing a nodule with slight high intensity on a T2-weighted image and high intensity on a diffusion-weighted image. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced dynamic MRI showing a nodule with defects in the hepatocyte phase in segments 2, 3 (arrow), 4, and 8 of the liver
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608947&req=5

Fig2: Magnetic resonance imaging (MRI) showing a nodule with slight high intensity on a T2-weighted image and high intensity on a diffusion-weighted image. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced dynamic MRI showing a nodule with defects in the hepatocyte phase in segments 2, 3 (arrow), 4, and 8 of the liver
Mentions: Imaging revealed four nodules measuring up to 13 mm in diameter in segments 2, 3, 4, and 8 of the liver. Ultrasonography revealed low echoic lesions in segments 2 (13 mm in diameter) and 3 (8 mm in diameter) of the liver. On contrast-enhanced ultrasonography using perflubutane, these lesions showed enhancement in the arterial phase, subsequent washout in the portal phase, and defects in the Kupffer phase. On contrast-enhanced CT, these nodules showed ring enhancement in the arterial phase and subsequent washout in the portal phase. In addition, small nodules with the same enhancement pattern were identified in segments 4 and 8 (Fig. 1). CT arterial portography revealed nodular perfusion defects, and CT hepatic arteriography revealed strong enhancement in the early phase and ring enhancement in the late phase. Magnetic resonance imaging (MRI) showed low intensity on T1 weighted images, slightly high intensity on T2 weighted images, and high intensity on diffusion-weighted images. On gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced dynamic MRI, the nodules showed ring enhancement in the arterial phase and defects in the hepatocyte phase (Fig. 2). The patient also underwent whole-body positron emission tomography-computed tomography, and all lesions had standardized uptake values up to 4.6.Fig. 1

View Article: PubMed Central

ABSTRACT

Pseudolymphoma is a benign lymphocytic tumor-like lesion, and its occurrence in the liver is rare. Here, we report the case of a 78-year-old woman with pseudolymphoma of the liver. She had a history of tremors for several years. Therefore, she underwent computed tomography (CT) for screening, and liver tumors were incidentally identified. She did not have any history of liver disease. Liver function test results and tumor marker levels were all within normal limits, and viral markers for hepatitis were negative. Contrast-enhanced CT revealed four nodules measuring up to 13 mm in diameter with ring enhancement in both lobes of the liver. On magnetic resonance imaging, the lesions showed slightly high intensity on T2-weighted images and high intensity on diffusion-weighted images. Because of atypical imaging findings, the tumors could not be definitively diagnosed. Therefore, we performed laparoscopic limited resection of segments 2, 3, 4, and 8 of the liver. The final pathological diagnosis was pseudolymphoma of the liver. The patient has had no signs of recurrence for 6 months after the surgery. Although pseudolymphoma of the liver is rare, it is necessary to consider it in the differential diagnosis of a liver tumor.

No MeSH data available.


Related in: MedlinePlus