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CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(04): 361-368
DOI: 10.4103/JLP.JLP_63_19
Original Article

Inflammatory pseudotumors of the liver: Importance of a multimodal approach with the insistance of needle biopsy

Neha Nigam
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Shikha Singh Rajani
Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Archana Rastogi
Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Anupama Patil
Department of Clinical Haematology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Nikhil Agrawal
Department of Hepato-Pancreato-Biliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India
,
Binit Sureka
Department of Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Asit Arora
Department of Hepato-Pancreato-Biliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India
,
Chhagan Bihari
Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

CONTEXT: Inflammatory pseudotumor (IPT) of the liver is a rare, tumor-like lesion that is considered to be biologically benign but often mimics malignancy.

AIMS: The aim of the study was construe clinicopathological features, imaging findings, differential diagnosis, management, and follow-up of IPT involving the liver.

SETTINGS AND DESIGN: It is a retrospective study.

SUBJECTS AND METHODS: Cases included were of IPT, diagnosed on histopathology, at our center from June 2009 to December 2016. Details studied were clinical presentation, imaging studies, laboratory investigations, pathological features, treatment, and follow-up of the cases and compared with reports in the literature.

RESULTS: A total of cases of IPT included were 17. The age of the patients ranged from 21 to 62 years. Common presenting features were intermittent fever, upper abdominal pain, and weight loss. Radiological diagnosis varied from neoplastic (13) to infectious etiologies (4), with hepatocellular carcinoma being the most common differential (7/17). Laboratory investigations revealed leukocytosis, hyperbilirubinemia, raised transaminases, and raised serum alkaline phosphatase. Core biopsy of a tumor conceded increased fibrosis along with mixed inflammatory cell infiltrates. Eleven cases were managed conservatively and showed regression or complete recovery. Six patients underwent surgical resection. None of these had any recurrence in median follow-up of 22 months.

CONCLUSIONS: IPT of the liver can masquerade as a fatality, either primary or metastatic. It will be well managed with conservative modalities and can avoid redundant hepatectomy, reserved for complicated cases. For this intent, accurate preoperative diagnosis is the requisite, and needle biopsy with or without fine-needle aspiration cytology plays as a significant rescuer in this field.

Key words

Antibiotics - inflammatory pseudotumor - liver


Publication History

Received: 02 May 2019

Accepted: 07 November 2019

Article published online:
07 April 2020

© 2019.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

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