Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 28, 2009; 15(36): 4587-4592
Published online Sep 28, 2009. doi: 10.3748/wjg.15.4587
Pseudolymphoma of the liver associated with primary biliary cirrhosis: A case report and review of literature
Toshihide Okada, Hiroshi Mibayashi, Kenkei Hasatani, Yoshiaki Hayashi, Shigetsugu Tsuji, Yoshibumi Kaneko, Masashi Yoshimitsu, Takashi Tani, Yoh Zen, Masakazu Yamagishi
Toshihide Okada, Hiroshi Mibayashi, Kenkei Hasatani, Yoshiaki Hayashi, Shigetsugu Tsuji, Yoshibumi Kaneko, Masashi Yoshimitsu, Masakazu Yamagishi, Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1, Takaramachi, Kanazawa 920-8641, Japan
Takashi Tani, Department of Gastroenterologic Surgery, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa 920-8641, Japan
Yoh Zen, Department of Human Pathology, Kanazawa University Hospital, Kanazawa 920-8641, Japan
Author contributions: Okada T and Mibayashi H contributed equally to this work; Hasatani K, Hayashi Y, Tsuji S, Kaneko Y and Yoshimitsu M perfomed clinical examinations; Tani T was in charge of surgery; Zen Y was in charge of pathological diagnosis; Okada T, Mibayashi H and Yamagishi M wrote the paper.
Correspondence to: Toshihide Okada, MD, Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1,Takaramachi, Kanazawa 920-8641, Japan. okada351116@yahoo.co.jp
Telephone: +81-76-2652000 Fax: +81-76-2344251
Received: April 10, 2009
Revised: August 14, 2009
Accepted: August 21, 2009
Published online: September 28, 2009
Abstract

We report a case of two pseudolymphomas of the liver in a 63-year-old Japanese woman with primary biliary cirrhosis. One of the lesions was found incidentally during a medical examination, presenting as a 10 mm hypodense nodule that revealed hyperdensity in the early phase and hypodensity in the late phase in computed tomography (CT) after injection of contrast medium. Retrospectively, the 10 mm nodule had first been discovered as a 4 mm nodule during CT 4 years previously. Superparamagnetic iron oxide-enhanced MRI revealed another 4 mm hyperintense nodule in segment 6 in addition to the 10 mm hyperintense nodule in segment 7. CT during arterial portography revealed two hypointense nodules. Findings with other imaging modalities such as ultrasonography, magnetic resonance imaging, and hepatic angiography were consistent with hepatocellular carcinoma. A right posterior segmentectomy was performed, and the lesions were microscopically diagnosed as pseudolymphoma. To the best of our knowledge, only 31 other cases of this disease have ever been reported, with a highly asymmetrical male:female ratio of 1:9.7. Although we could find only one case of transformation of hepatic pseudolymphoma into lymphoma in the liver, the exact nature of development from benign pseudolymphoma to malignant lymphoma is still not fully understood and cases of hepatic lymphoma need to be followed carefully.

Keywords: Liver diseases; Pseudolymphoma; Primary biliary cirrhosis