A Case of Inflammatory Pseudotumor of the Liver Associated with Hepatolithiasis

Nobuhiko Ueda, Ichiro Konishi, Teisuke Hirono

Department of Surgery, Toyama City Hospital

A case of inflammatory pseudotumor of the liver associated with hepatolithiasis is reported. A 74-year-old woman complained of fever and general malaise. Laboratory findings on admission revealed a severe inflammatory reaction and elevation of bile duct enzymes. Abdominal ultrasonography demonstrated many stones in the intra and extra bile ducts. The periphery of the lateral segment of the liver was swollen because of a low echoic area with cystic lesions. Abdonimal CT with enhancement on arterial dominant phase revealed multiple ringed enhanced lesions with a multilocular cystic area at the periphery of S3. CT arteriography on the 10th day after admission revealed reduction of the swollen low echoic area. The size of each lesion was reduced in consequence of disappearance of cystic area and the lesions were disk-likely enhanced. Under the diagnosis of intra- and extrahepatic type hepatolithiasis and a liver abscess, biliary lithotomy and lateral segmentectomy were performed. Multiple yellow-white solid nodules were recognized at the periphery of S3. Pathologically solitary or gatherings of inflammatory nodules with Glisson's capsule in the center consisted mainly of lymphocytes and histiocytes and her codition was diagnosed as IPTs.

Key words
inflammatory pseudotumor of the liver, hepatolithiasis

Reprint requests
Nobuhiko Ueda Department of Surgery, Toyama City Hospital
292 Imaizumi, Toyama, 939-8511 JAPAN

Accepted
May 19, 1998

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