Ishida M, Nakahara T, Mochizuki Y, Tsujikawa T, Andoh A, Saito Y, Yamamoto H, Kojima F, Hotta M, Tani T, Fujiyama Y, Okabe H. Hepatic reactive lymphoid hyperplasia in a patient with primary biliary cirrhosis. World J Hepatol 2010; 2(10): 387-391 [PMID: 21160948 DOI: 10.4254/wjh.v2.i10.387]
Corresponding Author of This Article
Mitsuaki Ishida, MD, PhD, Assistant Professor, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan. mitsuaki@belle.shiga-med.ac.jp
Article-Type of This Article
Case Report
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Mitsuaki Ishida, Fumiyoshi Kojima, Machiko Hotta, Hidetoshi Okabe, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Tamio Nakahara, Tomoyuki Tsujikawa, Akira Andoh, Yoshihide Fujiyama, Department of Gastroenterology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Yousuke Mochizuki, Yasuharu Saito, Division of Endoscopy, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Hiroshi Yamamoto, Tohru Tani, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Author contributions: Ishida M interpreted the data; Ishida M and Okabe H wrote the manuscript; and all the authors contributed to analyzing the patient’s data.
Correspondence to: Mitsuaki Ishida, MD, PhD, Assistant Professor, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan. mitsuaki@belle.shiga-med.ac.jp
Telephone: +81-77-5482603 Fax: +81-77-5482407
Received: May 18, 2010 Revised: August 6, 2010 Accepted: August 13, 2010 Published online: October 27, 2010
Abstract
Reactive lymphoid hyperplasia (RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles. Hepatic RLH is known to be associated with gastrointestinal carcinoma and autoimmune diseases including primary biliary cirrhosis (PBC). We report a case of hepatic RLH in a patient with PBC and gastric cancer. A 68 year old Japanese woman with a 10 year history of liver enzyme abnormality was admitted. Laboratory testing revealed that her anti-mitochondrial antibody was markedly elevated. Five mo after the diagnosis of PBC, she was found to have gastric cancer. Abdominal computed tomography disclosed a liver nodule in S8, suggesting metastatic gastric carcinoma. Histopathologically, the resected liver lesion comprised of a nodular proliferation of small lymphocytes with lymphoid follicles. This is the first reported case of hepatic RLH in a patient with both PBC and gastric cancer. Pre-operative diagnosis of hepatic RLH by clinical imaging is extremely difficult. Therefore, a needle biopsy could be useful to make a diagnosis of hepatic RLH, especially to differentiate from metastatic gastrointestinal carcinoma.
