Case Report
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2005; 11(6): 922-925
Published online Feb 14, 2005. doi: 10.3748/wjg.v11.i6.922
Inflammatory pseudotumor of the liver and peripheral eosinophilia in autoimmune pancreatitis
Naoki Sasahira, Takao Kawabe, Akira Nakamura, Kenji Shimura, Haruhisa Shimura, Ei Itobayashi, Manabu Asada, Yasushi Shiratori, Masao Omata
Naoki Sasahira, Takao Kawabe, Masao Omata, Department of Gastroenterology, University of Tokyo, Tokyo 113-8655, Japan
Akira Nakamura, Kenji Shimura, Haruhisa Shimura, Ei Itobayashi, Manabu Asada, Department of Gastroenterology, Asahi General Hospital, Chiba, Japan
Yasushi Shiratori, Department of Gastroenterology, University of Okayama, Okayama, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Naoki Sasahira, M.D., Department of Gastroenterology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. sasahira-tky@umin.ac.jp
Telephone: +81-3-3815-5411
Received: May 10, 2004
Revised: May 14, 2004
Accepted: September 9, 2004
Published online: February 14, 2005
Abstract

AIM: Inflammatory pseudotumor (IPT) of the liver is a rare benign lesion, the etiology of which remains obscure. It is not associated with any particular diseases apart from phlebitis and Crohn’s disease.

METHODS: A middle-aged male with hepatic IPT and peripheral eosinophilia associated with autoimmune pancreatitis (AIP) was selected for this study and review of literature.

RESULTS: A 59-year-old male was admitted with obstructive jaundice, marked eosinophilia (1343/mm3) and hypergammaglobulinemia (4145 mg/dL). Imaging techniques revealed dilatation of the intrahepatic bile duct, stenosis of the common bile duct with diffuse wall thickening, gallbladder wall thickening, irregular narrowing of the pancreatic duct, and swelling of the pancreatic parenchyma. Multiple liver masses were also demonstrated and diagnosed as IPT by biopsy specimens. Six months later, the abnormal features of the biliary tree remarkably improved by the oral administration of prednisolone, and the liver masses disappeared. The swelling of the pancreatic head also improved. The peripheral eosinophil count normalized. IPT associated with AIP, as we know, has not been reported in the literature. The clinical features of the present case mimicked those of pancreatic cancer with liver metastasis. This case deserves to be documented to prevent misdiagnosis of similar cases.

Keywords: Inflammatory pseudotumor; Autoimmune pancreatitis