A Case of Granulomatous Abscess of the Liver detected by ¹⁸F-fluorodeoxyglucose Positron Emission Tomography which is Very Difficult to Differ from Cholangiocellular Carcinoma

Takashi Masuda, Hiroki Uchida, Kentaro Iwaki, Hidetoshi Eguchi, Yuichi Endo, Yoshiki Okunaga, Seiichiro Kai, Kohei Shibata, Masayuki Ohta and Seigo Kitano

Department of Surgery I, Oita University Faculty of Medicine

A 53-year-old woman admitted for abnormal metabolic activity in the left lateral hepatic segment detected by ¹⁸F-fluorodeoxyglucose positron emission tomography had a history of cholecystolithiasis, choledocolithiasis, and acute pancreatitis. Abdominal enhanced computed tomography showed a ring-like enhanced tumor lesion 3 cm in diameter in segment S3 of the liver, necessitating left lateral segmentectomy based on a preoperative diagnosis of cholangiocellular carcinoma. Macroscopically, the tumor, a yellowish white hard mass in the resected specimen, was considered cholangiocellular carcinoma. Postoperative pathological examination showed, however, that the lesion was not tumorous and had only fibrosis and proliferation of inflammatory cells and fibroblasts, leading to a diagnosis of granulomatous abscess. It is thus important to consider granulomatous abscess as a differential diagnosis of cholangiocellular carcinoma in a patient who has a history of biliary tract surgery.

Key words
granulomatous abscess, FDG-PET, cholangiocellular carcinoma

Reprint requests
Takashi Masuda Departments of Surgery I, Oita University Faculty of Medicine
1-1 Idaigaoka, Hasama-machi, Yufu, 879-5593 JAPAN

Accepted
April 23, 2008

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