Clinical Features, Image Findings, and Prognosis of Inflammatory Pseudotumor of the Liver: A Multicenter Experience of 45 Cases
Clinical Features, Image Findings, and Prognosis of Inflammatory Pseudotumor of the Liver: A Multicenter Experience of 45 Cases
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DOI：
10.5009/gnl.2014.8.1.58
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发表时间：
2014-01-01
期刊：
影响因子：
3.4
通讯作者：
Yoo, Byung Chul
中科院分区：
文献类型：
--
作者：
Park, Jun Young;Choi, Moon Seok;Yoo, Byung Chul
背景/目的：肝脏炎性假瘤（IPT）是一种罕见的疾病，其特征是炎症细胞的慢性浸润。然而，IPT的临床特点和结果仍然不确定。方法：对55例经组织学证实的IPT患者的临床特征、影像学表现和预后进行评估。结果：男性26例，女性19例，中位年龄65岁。42例（93.3%）患者血清癌胚抗原和糖类抗原19-9水平正常。增强CT扫描显示动脉期周围强化模糊（82.5%），平衡期高衰减区模糊伴内部低衰减区（77.0%）。钆增强MRI显示周围边缘样强化模糊（77.8%）。10例接受手术切除，35例保守治疗，使用或不使用抗生素。术后随访1 ~ 48个月无复发。在所有接受保守治疗的患者中，在随访期间（1至192个月）观察到完全消退或体积缩小。结论：CT和MRI对肝脏肿块和正常肿瘤标志物患者的IPT诊断提供了线索。然而，由于缺乏病理表现，临床医生的怀疑和组织学诊断是必要的，以作出准确的。IPT的诊断。
Background/Aims: Inflammatory pseudotumor (IPT) of the liver is a rare disease characterized by chronic infiltration of inflammatory cells. However, the clinical characteristics and outcomes of IPT remain uncertain. Methods: Clinical features, image findings, and outcomes of 55 patients with histologically proven IPT were evaluated. Results: They consisted of 26 men and 19 women with median age of 65 years. Serum carcinoembryonal antigen and carbohydrate antigen 19-9 levels were normal in 42 patients (93.3%). Enhanced CT scans indicated poorly defined peripheral enhancement (82.5%) at the arterial phase and poorly defined hyperattenuating lesions with internal hypoattenuating areas at the equilibrium phase (77.0%). Gadolinium-enhancement MRI revealed poorly defined peripheral rim-like enhancement (77.8%). Ten patients underwent surgical resection and 35 were treated conservatively with or without antibiotics. No recurrence was noted after surgical resection during follow-up (1 to 48 months). In all patients who received conservative treatment, complete resolution or size reduction was noted during follow-up (1 to 192 months). Conclusions: CT and MRI provide clues to the diagnosis of IPT in patients with liver masses and normal tumor markers. However, due to the lack of pathognomonic findings, the clinician's suspicion and histological diagnosis are necessary to make an accurate. diagnosis of IPT.