Inflammatory pseudotumor of the liver and spleen diagnosed by percutaneous needle biopsy

World J Gastroenterol. 2012 Jan 7;18(1):90-5. doi: 10.3748/wjg.v18.i1.90.

Abstract

An inflammatory pseudotumor (IPT) is a relatively rare lesion characterized by chronic infiltration of inflammatory cells and areas of fibrosis. IPTs are difficult to diagnose because of the absence of specific symptoms or of characteristic hematological or radiological findings. In this study, a case of a woman aged over 70 years was reported, who presented with a general malaise lasting more than two months. A computed tomography scan demonstrated a diffusely spread lesion of the liver with a portal vein occlusion and a splenic lesion surrounded by a soft density layer. Since the percutaneous liver biopsy showed findings that suggested an IPT, although the radiological findings did not exclude the possibility of a malignancy, we performed a percutaneous spleen biopsy to enable a more definitive diagnosis. The microscopic findings from the spleen specimen lead us to a diagnosis of IPT involving the liver and spleen. Subsequent steroid pulse therapy was effective, and rapid resolution of the disease was observed.

Keywords: Inflammatory pseudotumor; Percutaneous liver biopsy; Percutaneous spleen biopsy; Steroid pulse therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy, Needle / methods
  • Female
  • Granuloma, Plasma Cell* / diagnosis
  • Granuloma, Plasma Cell* / pathology
  • Granuloma, Plasma Cell* / surgery
  • Humans
  • Liver Diseases* / diagnosis
  • Liver Diseases* / pathology
  • Liver Diseases* / surgery
  • Liver* / diagnostic imaging
  • Liver* / pathology
  • Liver* / surgery
  • Positron-Emission Tomography
  • Spleen* / diagnostic imaging
  • Spleen* / pathology
  • Spleen* / surgery
  • Splenic Diseases* / diagnosis
  • Splenic Diseases* / pathology
  • Splenic Diseases* / surgery
  • Tomography, X-Ray Computed