Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2019; 25(45): 6693-6703
Published online Dec 7, 2019. doi: 10.3748/wjg.v25.i45.6693
Imaging findings of inflammatory pseudotumor-like follicular dendritic cell tumors of the liver: Two case reports and literature review
Hai-Lan Li, Hua-Ping Liu, Grace Wen-Jun Guo, Zhi-Hong Chen, Fu-Qing Zhou, Peng Liu, Jian-Bin Liu, Ren Wan, Zhi-Qun Mao
Hai-Lan Li, Peng Liu, Department of Radiology, Hunan Provincial People's Hospital (the First Affiliate Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China
Hua-Ping Liu, Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China
Grace Wen-Jun Guo, Department of Radiology, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE 19803, United States
Zhi-Hong Chen, Department of Pathology, Hunan Provincial People's Hospital (the First Affiliate Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China
Fu-Qing Zhou, Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Jian-Bin Liu, Ren Wan, Zhi-Qun Mao, Department of Radiology, Hunan Provincial People's Hospital(the First Affiliate Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China
Author contributions: Li HL and Mao ZQ carried out the design, literature search, and manuscript preparation; Liu HP, Liu P, Liu JB and Wan R collected important background information and analyzed the imaging findings; Chen ZH provided assistance for Pathologic analysis; Li HL did data analysis and drafted the manuscript; Mao ZQ, Guo GWJ and Zhou FQ contributed to manuscript drafting and revising; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Qun Mao, MD, Professor, Department of Radiology, Hunan Provincial People's Hospital(the First Affiliate Hospital of Hunan Normal University), No. 61 JieFangXi Road, Changsha 410005, Hunan Province, China. maozhiqunradiology@163.com
Telephone: +86-731-83929025 Fax: +86-731-82278012
Received: October 17, 2019
Peer-review started: October 17, 2019
First decision: November 10, 2019
Revised: November 21, 2019
Accepted: November 23, 2019
Article in press: November 23, 2019
Published online: December 7, 2019
Processing time: 50 Days and 3.1 Hours
Abstract
BACKGROUND

Inflammatory pseudotumor-like follicular dendritic cell (IPT-like FDC) tumors of the liver is an uncommon tumor with extremely low incidence. To date, the radiologic findings of this tumor in multiphase computed tomography (CT) and magnetic resonance imaging (MRI) imaging have not been described.

CASE SUMMARY

Patient 1 is a 31-year-old Chinese female, whose complaining incidentally coincided with the finding of multiple liver masses. In the local hospital, an abdominal enhanced CT found two hypo-dense solid lesions, with heterogeneous sustained hypoenhancement, in the upper segment of the liver’s right posterior lobe. In our hospital, enhanced magnetic resonance imaging (MRI) with hepatocyte-specific contrast agents showed a similar enhanced pattern of lesions with patchy hyperintensity in the hepatobiliary phase (HBP). The patient underwent surgery and recovered well. The final pathology confirmed an IPT-like FDC tumor. No recurrence was found on the regular re-examination. Patient 2 is a 48-year-old Chinese male admitted to our hospital for a huge unexpected hepatic lesion. A dynamic enhanced abdominal CT revealed a huge heterogeneous enhanced solid tumor in the right lobe of the liver with a size of 100 mm × 80 mm, which showed a heterogeneous sustained hypoenhancement. In addition, enlarged lymph nodes were found in the hilum of the liver. This patient underwent a hepatic lobectomy and lymph node dissection. The final pathology confirmed an IPT-like FDC tumor. No recurrence was found upon regular re-examination.

CONCLUSION

When a hepatic tumor shows heterogeneous sustained hypoenhancement with a patchy enhancement during HBP, an IPT-like FDC tumor should be considered in the differential diagnosis.

Keywords: Magnetic resonance imaging; Computed tomography; Inflammatory pseudotumor-like follicular dendritic cell tumor; Liver

Core tip: Here we report two rare cases of inflammatory pseudotumor-like follicular dendritic cell tumors of the liver, and give the first description of multiphase computed tomography and magnetic resonance imaging features of these tumors. Radiologists should be alerted to this disease for the differential diagnosis of liver tumors.