Reactive lymphoid hyperplasia of the liver: Perinodular enhancement on contrast-enhanced computed tomography and magnetic resonance imaging

doi:10.3748/wjg.v21.i21.6759

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World Journal of Gastroenterology

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Case Report

World J Gastroenterol. Jun 7, 2015; 21(21): 6759-6763
Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6759

Reactive lymphoid hyperplasia of the liver: Perinodular enhancement on contrast-enhanced computed tomography and magnetic resonance imaging

Tetsuo Sonomura, Shinpei Anami, Taizo Takeuchi, Motoki Nakai, Shinya Sahara, Hirohiko Tanihata, Kazuki Sakamoto, Morio Sato

Tetsuo Sonomura, Shinpei Anami, Taizo Takeuchi, Motoki Nakai, Morio Sato, Department of Radiology, Wakayama Medical University, Wakayama 641-8510, Japan

Shinya Sahara, Hirohiko Tanihata, Department of Radiology, Kishiwada Tokushukai Hospital, Kishiwada-shi 596-8522, Japan

Kazuki Sakamoto, Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada-shi 596-8522, Japan

Author contributions: Sahara S and Tanihata H performed diagnostic imaging; Sakamoto K performed partial hepatectomy; Sonomura T, Anami S, Takeuchi T and Nakai M acquired the data and researched the literature; Sonomura T and Sato M drafted and edited the manuscript.

Ethics approval: The patient had a standard treatment that was approved ethically.

Informed consent: Informed consent was obtained in a routine manner.

Conflict-of-interest: The authors declare that they have no conflict of interest.

Correspondence to: Tetsuo Sonomura, MD, PhD, Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan. sonomura@wakayama-med.ac.jp

Telephone: +81-73-441-0605 Fax: +81-73-444-3110

Received: November 5, 2014
Peer-review started: November 9, 2014
First decision: November 26, 2014
Revised: December 10, 2014
Accepted: February 5, 2015
Article in press: February 5, 2015
Published online: June 7, 2015
Processing time: 217 Days and 21.6 Hours

Abstract

We report the case of a 69-year-old woman with reactive lymphoid hyperplasia (RLH) of the liver. She underwent partial hepatectomy under a preoperative diagnosis of hepatocellular carcinoma; however, histopathological analysis revealed RLH. The liver nodule showed the imaging feature of perinodular enhancement in the arterial dominant phase on contrast-enhanced computed tomography and magnetic resonance imaging, which could be a useful clue for identifying RLH in the liver. Histologically, the perinodular enhancement was compatible with prominent sinusoidal dilatation surrounding the liver nodule.

Keywords: Reactive lymphoid hyperplasia; Liver; Perinodular enhancement; Computed tomography; Magnetic resonance imaging

Core tip: It is difficult to differentiate between reactive lymphoid hyperplasia (RLH) of the liver and malignant liver tumors such as hepatocellular carcinoma and liver metastases. We observed a liver nodule with perinodular enhancement in the arterial dominant phase on contrast-enhanced computed tomography and magnetic resonance imaging. We consider that this imaging feature could be a useful clue for identifying RLH in the liver. Histological analysis revealed the liver nodule in our patient to be RLH, with prominent sinusoidal dilatation around the nodule. This dilatation is the cause of the perinodular enhancement, which is useful for the accurate diagnosis of RLH.