Reactive Lymphoid Hyperplasia of the liver in a patient with colon cancer: report of two cases
Reactive Lymphoid Hyperplasia of the liver in a patient with colon cancer: report of two cases
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DOI：
10.1186/1471-230x-6-25
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发表时间：
2006-09-12
影响因子：
2.4
通讯作者：
Manabe, Tadao
中科院分区：
文献类型：
--
作者：
Takahashi, Hiroki;Sawai, Hirozumi;Manabe, Tadao
背景：肝脏的反应性淋巴样增生（RLH）是非常罕见的报道，我们遇到了两个肝癌患者的肝脏RLH。病例介绍：在第一个病例中，一位77岁的妇女因手术切除升结肠癌而入院。左肝肿瘤同时被计算机断层扫描（CT）和磁共振成像（MRI）发现。外观提示肝转移。行右半结肠切除术和部分肝切除术。组织病理学检查，肿瘤样病变可见生发中心淋巴滤泡，结节周围门静脉区可见生发中心淋巴浸润。免疫组化研究显示浸润淋巴细胞多克隆。因此，这个结节状病变被诊断为肝脏RLH。在第二个病例中，一名64岁的女性，10年前因II期升结肠癌行根治性右半结肠切除术，因排尿困难入院。CT和MRI同时显示左叶肝肿瘤，提示肝细胞癌。行左外侧节段切除术。显微镜下，该病变与第一例几乎相同，因此诊断为肝脏RLH。结论：这2例为首次报道的肝癌合并RLH病例。由于病例很少，因此不清楚恶性肿瘤是否参与RLH的发病。但我们相信，通过仔细监测这两名患者的临床过程，可能会发现涉及RLH发病机制的新因素。
Background: Reactive lymphoid hyperplasia (RLH) of the liver is very rarely reported, and we encountered two cases of RLH of the liver in a patient with colon cancer.Case presentation: In the first case, a 77-year-old woman was admitted for the surgical removal of a ascending colon cancer. A hepatic tumor in the left lobe was concurrently revealed by computed tomography (CT), and magnetic resonance imaging (MRI). The appearance suggested liver metastasis. Right hemicolectomy and partial hepatectomy were performed. On histopathological examination, lymphoid follicles with germinal centers were seen in the tumor-like lesion, and remarkable lymphoid infiltration with germinal centers was seen in the portal area around the nodule. Immunohistochemical studies revealed polyclonality of infiltrating lymphocyte. Consequently, this nodular lesion was diagnosed as RLH of the liver. In the second case, a 64-year-old woman who had a radical right hemicolectomy for stage II ascending colon cancer 10 years ago was admitted with dysuria. A hepatic tumor in the left lobe was concurrently revealed by CT and MRI, suggesting hepatocellular carcinoma. A left lateral segmentectomy was performed. Microscopically, this lesion revealed the almost same findings as the first case, so this nodular lesion was diagnosed as RLH of the liver.Conclusion: Our two cases were the first report of RLH of the liver accompanying colon cancer. Because there are a very few cases, so it is not clear whether the malignancies were involved in the onset of RLH. But we believe that new factors involved in the onset mechanism of RLH may be identified by carefully monitoring the clinical course of our two patients.