Hepatic Inflammatory Pseudotumor: An Important Differential Diagnosis in Patients With a History of Previous Biliary Procedures

Jianping Zhao; Kelly Olino; Leah E Low; Suimin Qiu; Heather L Stevenson

doi:10.14309/crj.0000000000000015

Hepatic Inflammatory Pseudotumor: An Important Differential Diagnosis in Patients With a History of Previous Biliary Procedures

ACG Case Rep J. 2019 Feb 13;6(1):e00015. doi: 10.14309/crj.0000000000000015. eCollection 2019 Jan.

Authors

Jianping Zhao¹, Kelly Olino², Leah E Low³, Suimin Qiu¹, Heather L Stevenson¹

Affiliations

¹ Department of Pathology, University of Texas Medical Branch, Galveston, TX.
² Department of Surgery, University of Texas Medical Branch, Galveston, TX.
³ Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX.

Abstract

Hepatic inflammatory pseudotumors (IPTs) are rare lesions that mimic malignancy clinically, radiologically, and pathologically. The pathophysiology is unknown, and no criteria exist for diagnosis. This series includes 3 cases: 1 patient had recent biliary drainage with bile duct stent placement, and the other 2 patients had hepatic abscess formation before IPT development, which further supports that hepatic IPTs develop in patients with underlying triggers of liver inflammation and injury, including infections and/or bile leakage into the parenchyma. All 3 patients were successfully treated with antibiotics, sparing them surgical intervention. Follow-up showed complete resolution, and none developed recurrences or malignancies.