Ishida M, Nakahara T, Mochizuki Y, Tsujikawa T, Andoh A, Saito Y, Yamamoto H, Kojima F, Hotta M, Tani T, Fujiyama Y, Okabe H. Hepatic reactive lymphoid hyperplasia in a patient with primary biliary cirrhosis. World J Hepatol 2010; 2(10): 387-391 [PMID: 21160948 DOI: 10.4254/wjh.v2.i10.387]
Corresponding Author of This Article
Mitsuaki Ishida, MD, PhD, Assistant Professor, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan. mitsuaki@belle.shiga-med.ac.jp
Article-Type of This Article
Case Report
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Mitsuaki Ishida, Fumiyoshi Kojima, Machiko Hotta, Hidetoshi Okabe, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Tamio Nakahara, Tomoyuki Tsujikawa, Akira Andoh, Yoshihide Fujiyama, Department of Gastroenterology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Yousuke Mochizuki, Yasuharu Saito, Division of Endoscopy, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Hiroshi Yamamoto, Tohru Tani, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Author contributions: Ishida M interpreted the data; Ishida M and Okabe H wrote the manuscript; and all the authors contributed to analyzing the patient’s data.
Correspondence to: Mitsuaki Ishida, MD, PhD, Assistant Professor, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan. mitsuaki@belle.shiga-med.ac.jp
Telephone: +81-77-5482603 Fax: +81-77-5482407
Received: May 18, 2010 Revised: August 6, 2010 Accepted: August 13, 2010 Published online: October 27, 2010
Abstract
Reactive lymphoid hyperplasia (RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles. Hepatic RLH is known to be associated with gastrointestinal carcinoma and autoimmune diseases including primary biliary cirrhosis (PBC). We report a case of hepatic RLH in a patient with PBC and gastric cancer. A 68 year old Japanese woman with a 10 year history of liver enzyme abnormality was admitted. Laboratory testing revealed that her anti-mitochondrial antibody was markedly elevated. Five mo after the diagnosis of PBC, she was found to have gastric cancer. Abdominal computed tomography disclosed a liver nodule in S8, suggesting metastatic gastric carcinoma. Histopathologically, the resected liver lesion comprised of a nodular proliferation of small lymphocytes with lymphoid follicles. This is the first reported case of hepatic RLH in a patient with both PBC and gastric cancer. Pre-operative diagnosis of hepatic RLH by clinical imaging is extremely difficult. Therefore, a needle biopsy could be useful to make a diagnosis of hepatic RLH, especially to differentiate from metastatic gastrointestinal carcinoma.
Ishida M, Nakahara T, Mochizuki Y, Tsujikawa T, Andoh A, Saito Y, Yamamoto H, Kojima F, Hotta M, Tani T, Fujiyama Y, Okabe H. Hepatic reactive lymphoid hyperplasia in a patient with primary biliary cirrhosis. World J Hepatol 2010; 2(10): 387-391 [PMID: 21160948 DOI: 10.4254/wjh.v2.i10.387]
