Kwon YK, Jha RC, Etesami K, Fishbein TM, Ozdemirli M, Desai CS. Pseudolymphoma (reactive lymphoid hyperplasia) of the liver: A clinical challenge. World J Hepatol 2015; 7(26): 2696-2702 [PMID: 26609347 DOI: 10.4254/wjh.v7.i26.2696]
Corresponding Author of This Article
Chirag S Desai, MD, Transplant Institute, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC 20007, United States. chirag.s.desai@gunet.georgetown.edu
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Nov 18, 2015; 7(26): 2696-2702 Published online Nov 18, 2015. doi: 10.4254/wjh.v7.i26.2696
Pseudolymphoma (reactive lymphoid hyperplasia) of the liver: A clinical challenge
Yong Kyong Kwon, Reena C Jha, Kambiz Etesami, Thomas M Fishbein, Metin Ozdemirli, Chirag S Desai
Yong Kyong Kwon, Kambiz Etesami, Thomas M Fishbein, Chirag S Desai, Transplant Institute, MedStar Georgetown University Hospital, Washington, DC 20007, United States
Reena C Jha, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC 20007, United States
Metin Ozdemirli, Department of Pathology, MedStar Georgetown University Hospital, Washington, DC 20007, United States
Author contributions: All the authors contributed equally to this work with writing and editing; in addition, Ozdemirli M provided pathology images; Jha RC provided radiographic images.
Institutional review board statement: This case report was except from the institutional review board at MedStar Georgetown University Hospital.
Informed consent statement: The patients involved in this study gave their written informed consent authorizing use and disclosure of their protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chirag S Desai, MD, Transplant Institute, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC 20007, United States. chirag.s.desai@gunet.georgetown.edu
Telephone: +1-202-4446396 Fax: +1-877-6808192
Received: June 1, 2015 Peer-review started: June 4, 2015 First decision: August 14, 2015 Revised: September 5, 2015 Accepted: October 20, 2015 Article in press: October 27, 2015 Published online: November 18, 2015 Processing time: 171 Days and 6.3 Hours
Abstract
Reactive lymphoid hyperplasia (RLH), also known as pseudolymphoma or nodular lymphoid lesion of the liver is an extremely rare condition, and only 51 hepatic RLH cases have been described in the literature since the first case was described in 1981. The majority of these cases were asymptomatic and incidentally found through radiological imaging. The precise etiology of hepatic RLH is still unknown, but relative high prevalence of autoimmune disorder in these cases suggests an immune-based liver disorder. Imaging features of hepatic RLH often suggest malignant lesions such as hepatocellular carcinoma and cholangiocarcinoma. In this report, we discuss two cases of hepatic RLH in patients with autoimmune hepatitis. We also present pathologic and magnetic resonance imaging findings, including one case utilizing a hepatocellular contrast agent, Eovist. Definitive diagnosis of hepatic RLH often requires surgical excision.
Core tip: Reactive lymphoid hyperplasia of the liver also known as pseudolymphoma is an extremely rare condition. Because of its rarity, association with underlying inflammatory liver disease and close resemblance to malignant hepatic lesions such as hepatocellular carcinoma and cholangiocarcinoma on imaging studies, this rare lesion is frequently misdiagnosed. We discuss two cases of hepatic reactive lymphoid hyperplasia (RLH) in patients with autoimmune hepatitis and how we came to the correct diagnosis. Definitive diagnosis of hepatic RLH often requires surgical excision.
