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Kawaguchi T, Mochizuki K, Kizu T, Miyazaki M, Yakushijin T, Tsutsui S, Morii E, Takehara T. Inflammatory pseudotumor of the liver and spleen diagnosed by percutaneous needle biopsy. World J Gastroenterol 2012; 18(1): 90-95 [PMID: 22228976 DOI: 10.3748/wjg.v18.i1.90]
Tsukasa Kawaguchi, Kiyoshi Mochizuki, Takashi Kizu, Masanori Miyazaki, Takayuki Yakushijin, Shusaku Tsutsui, Tetsuo Takehara, Department of Gastroenterology and Hepatology, Osaka University Hospital, 2-15, Yamadaoka, Suita 565-0871, Japan
Eiichi Morii, Department of Pathology, Osaka University Hospital, 2-15, Yamadaoka, Suita 565-0871, Japan
Author contributions: Kawaguchi T designed the report; Mochizuki K, Kizu T, Miyazaki M, Yakushijin T and Tsutsui S were the attending doctors for the patient; Morii E performed pathological examinations; Takehara T organized the report; and Kawaguchi T and Mochizuki K wrote the paper.
Correspondence to: Kiyoshi Mochizuki, MD, PhD, Assistant Professor, Department of Gastroenterology and Hepatology, Osaka University Hospital, 2-15, Yamadaoka, Suita 565-0871, Japan. kmochizuki@gh.med.osaka-u.ac.jp
Telephone: +81-6-68793621 Fax: +81-6-68793629
Received: February 12, 2011 Revised: June 3, 2011 Accepted: June 10, 2011 Published online: January 7, 2012
Abstract
An inflammatory pseudotumor (IPT) is a relatively rare lesion characterized by chronic infiltration of inflammatory cells and areas of fibrosis. IPTs are difficult to diagnose because of the absence of specific symptoms or of characteristic hematological or radiological findings. In this study, a case of a woman aged over 70 years was reported, who presented with a general malaise lasting more than two months. A computed tomography scan demonstrated a diffusely spread lesion of the liver with a portal vein occlusion and a splenic lesion surrounded by a soft density layer. Since the percutaneous liver biopsy showed findings that suggested an IPT, although the radiological findings did not exclude the possibility of a malignancy, we performed a percutaneous spleen biopsy to enable a more definitive diagnosis. The microscopic findings from the spleen specimen lead us to a diagnosis of IPT involving the liver and spleen. Subsequent steroid pulse therapy was effective, and rapid resolution of the disease was observed.
