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Pseudolymphoma of the liver: a case report and literature review

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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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Image of a resected liver specimen showing a well-circumscribed, ash-colored tumor (a). On histological analysis, many aggregated lymphoid follicles are seen with germinal centers consisting of lymphocytic or plasmacytic cells without atypia (b: scale bar, 25 μm, c: scale bar 10 μm)
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Fig3: Image of a resected liver specimen showing a well-circumscribed, ash-colored tumor (a). On histological analysis, many aggregated lymphoid follicles are seen with germinal centers consisting of lymphocytic or plasmacytic cells without atypia (b: scale bar, 25 μm, c: scale bar 10 μm)

Mentions: On visual examination of the resected liver specimens, the tumors appeared well circumscribed and ash colored (Fig. 3). On histopathological examination of the tumors, many aggregated lymphoid follicles were noted with germinal centers consisting of lymphocytic or plasmacytic cells without atypia along with fibrocollagenous and hyalinized stroma. The lymphoid follicles varied in size and shape, and the germinal centers included small or large lymphoid cells and tingible body macrophages. On immunohistochemical examination of the tumors, CD3-positive cells were mainly localized in the parafollicular area, and CD20 and 79a immunostaining was positive in B follicles, while Bcl-2 staining was negative (Fig. 4). Thus, the possibility of well-defined follicular lymphoma was excluded, and pseudolymphoma of the liver was finally diagnosed. The patient has had no signs of recurrence for 6 months after the surgery.Fig. 3


Pseudolymphoma of the liver: a case report and literature review
Image of a resected liver specimen showing a well-circumscribed, ash-colored tumor (a). On histological analysis, many aggregated lymphoid follicles are seen with germinal centers consisting of lymphocytic or plasmacytic cells without atypia (b: scale bar, 25 μm, c: scale bar 10 μm)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Image of a resected liver specimen showing a well-circumscribed, ash-colored tumor (a). On histological analysis, many aggregated lymphoid follicles are seen with germinal centers consisting of lymphocytic or plasmacytic cells without atypia (b: scale bar, 25 μm, c: scale bar 10 μm)
Mentions: On visual examination of the resected liver specimens, the tumors appeared well circumscribed and ash colored (Fig. 3). On histopathological examination of the tumors, many aggregated lymphoid follicles were noted with germinal centers consisting of lymphocytic or plasmacytic cells without atypia along with fibrocollagenous and hyalinized stroma. The lymphoid follicles varied in size and shape, and the germinal centers included small or large lymphoid cells and tingible body macrophages. On immunohistochemical examination of the tumors, CD3-positive cells were mainly localized in the parafollicular area, and CD20 and 79a immunostaining was positive in B follicles, while Bcl-2 staining was negative (Fig. 4). Thus, the possibility of well-defined follicular lymphoma was excluded, and pseudolymphoma of the liver was finally diagnosed. The patient has had no signs of recurrence for 6 months after the surgery.Fig. 3

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