Inflammatory pseudotumor of the liver: Demographics, diagnosis, and the case for nonoperative management
Inflammatory pseudotumor of the liver: Demographics, diagnosis, and the case for nonoperative management
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DOI：
10.1016/s1072-7515(02)01495-3
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发表时间：
2003-02-01
影响因子：
5.2
通讯作者：
McCall, JL
中科院分区：
文献类型：
--
作者：
Koea, JB;Broadhurst, GW;McCall, JL
背景：肝脏炎性假肿瘤（IPL）是一种不寻常的肿瘤样疾病，在表现为肝脏肿块的患者中被认为是一种重要的鉴别诊断。本报告描述了6例IPL。研究设计：前瞻性地收集了6例到专科肝胆科就诊的患者的临床、诊断、病理和随访资料。结果：6例IPL患者在2年内出现。中位年龄为35岁（范围2 - 79岁），5例患者为男性。三名病人是波利尼西亚人（汤加人和萨摩亚人），一名是新西兰毛利人。5例患者出现非特异性症状（发热、关节痛、肌痛），1例患者出现IPL。入院时，4例患者白细胞计数升高，5例患者肝功能异常，碱性磷酸酶和γ -谷氨酰转移酶升高最为常见。所有患者的致癌胚胎抗原和甲胎蛋白均正常，尽管其中一人是已知的乙型肝炎携带者。在所有IPL病例中，诊断都是通过肝脏病灶的核心活检进行的，所有患者都进行了非手术治疗，肿瘤完全消退。两名患者口服类固醇短期治疗后，全身症状（发热和疼痛）明显减轻。结论：IPL似乎是毛利人和波利尼西亚人相对常见的问题。识别和区分这种情况与恶性肝脏病变是重要的，以避免不必要的手术。[J]中华外科杂志2003；19(3):229 - 229。(C) 2003年由美国外科医师学会发布)。
BACKGROUND: Inflammatory pseudotumor of the liver (IPL) is an unusual tumor-like condition that is becoming recognized as an important differential diagnosis in the patient presenting with liver masses. This report describes six cases of IPL.STUDY DESIGN: Clinical, diagnostic, pathologic, and followup data were collected prospectively on six patients presenting to a specialist hepatobillary unit.RESULTS: Six patients with IPL presented over a 2-year period. Median age was 35 years (range 2 to 79 years) and five patients were men. Three patients were Polynesian (Tongan and Samoan) and one was New Zealand Maori. Five patients presented with nonspecific symptoms (fever, arthralgia, myalgia) and IPL was an incidental finding in one patient. At presentation, four patients had elevated white cell counts, and five patients had abnormal liver function tests with elevations in alkaline phosphotase and gamma-glutamyl transferase the most commonly seen. Carcinogenic embryonic antigen and alpha fetoprotein were normal in all patients, although one was a known hepatitis B carrier. In all cases of IPL, diagnosis was made on core biopsy of the liver lesions and all patients were managed nonoperatively with complete resolution of the tumors. Two patients had marked reduction in systemic symptoms (fever and pain) from a short course of oral steroids.CONCLUSIONS: IPL appears to be a relatively common problem in Maori and Polynesians. Recognition and differentiation of this condition from malignant liver lesions are important to avoid unnecessary surgery. (J Am Coll Surg 2003; 196:226-235. (C) 2003 by the American College of Surgeons).