| Popis: |
A 65-year-old male patient with chief complaints of pyrexia and epigastralgia was treated. Examinations revealed anemia, an increased erythrocyte sedimentation rate, leukocytosis, polyclonal hyperimmunoglobulinemia and reactive hyperplasia of plasma cells in the bone marrow. Abdominal CT visualized a low-density area with an obscure demarcation in the posterior segment of the right hepatic lobe, and angiography showed vascular hyperplasia in the posterior branch of the right hepatic artery. Under a suspicion of liver abscess, exploratory centesis was preformed, but neither purulent discharge nor definite formation of an abscess cavity was found. By needle biopsy, the liver tissue was found to have been replaced by an inflammatory granulation tissue consisting of many plasma cells, lymphocytes and fibroblasts, but no microabscesses were observed. These findings led to the diagnosis of inflammatory pseudotumor of the liver (histopathologically, plasma cell granuloma). As a possible etiology of this disease, it was speculated that some immunological abnormality was involved, for our case presented with polyclonal hyperimmunoglobulinemia and hyperplasia of plasma cells in the bone marrow. |
