Inflammatory pseudotumor (IPT) of the liver is rare benign tumor. When the diagnosis of IPT is established with biopsy, simple observation or conservative therapy is preferred because of the possibility of regression. But IPT is unresponsive to the conservative treatment, surgical resection should be considered. We experienced a 63-year-old male, who was suspected hepatocellular carcinoma in abdominal computed tomography (CT) and magnetic resonance image (MRI) scan, presented with 2-month history of intermittent fever and weight loss. Percutaneous ultrasound guided core biopsy confirmed IPT of the liver. Non-steroidal anti-inflammatory drugs and antibiotics were administered for 8 and 4 weeks, respectively, but fever continued. So, extended right hepatectomy was performed for IPT of the liver and then fever subsided. The patient remains well during a follow-up period of 12 months.
Middle Aged ; Male ; Magnetic Resonance Imaging ; Liver Diseases/*diagnosis/pathology/*surgery ; Liver/pathology/surgery ; Humans ; *Hepatectomy ; Granuloma, Plasma Cell/*diagnosis/pathology/*surgery ; Diagnosis, Differential

Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; diagnosis ; Diagnosis, Differential ; Female ; Granuloma, Plasma Cell ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver ; pathology ; Middle Aged

The term inflammatory pseudotumor (IPT) has been used to describe inflammatory and fibrosing tumoral processes of an undetermined cause that may involve a variety of organ system. IgG4-related disease is a newly recognized fibroinflammatory condition characterized by IgG4-producing plasma cell expansion in affected organs and, often but not always, elevated serum IgG4 concentrations. IgG4-related IPTs, a subtype of IPT, are characterized by dense infiltration of IgG4-positive plasma cells and stromal fibrosis. The association between inflammatory pseudotumor and IgG4 was first reported with a regard to sclerosing pancreatitis. Despite there are many reports on intraperitoneal IPTs including both cellular and lymphoplasmacytic type, only a few cases have been confirmed to be IgG4-related. We experienced a case of intraperitoneal IgG4-related inflammatory pseudotumor in an 83-year-old woman presenting with epigastric pain and malaise. Surgical specimens revealed an IgG4-related inflammatory pseudotumor.
Aged, 80 and over ; C-Reactive Protein/analysis ; Female ; Granuloma, Plasma Cell/*diagnosis/pathology/surgery ; Humans ; Immunoglobulin G/*blood ; Plasma Cells/metabolism ; Positron-Emission Tomography ; Tomography, X-Ray Computed

The term inflammatory pseudotumor (IPT) has been used to describe inflammatory and fibrosing tumoral processes of an undetermined cause that may involve a variety of organ system. IgG4-related disease is a newly recognized fibroinflammatory condition characterized by IgG4-producing plasma cell expansion in affected organs and, often but not always, elevated serum IgG4 concentrations. IgG4-related IPTs, a subtype of IPT, are characterized by dense infiltration of IgG4-positive plasma cells and stromal fibrosis. The association between inflammatory pseudotumor and IgG4 was first reported with a regard to sclerosing pancreatitis. Despite there are many reports on intraperitoneal IPTs including both cellular and lymphoplasmacytic type, only a few cases have been confirmed to be IgG4-related. We experienced a case of intraperitoneal IgG4-related inflammatory pseudotumor in an 83-year-old woman presenting with epigastric pain and malaise. Surgical specimens revealed an IgG4-related inflammatory pseudotumor.
Aged, 80 and over ; C-Reactive Protein/analysis ; Female ; Granuloma, Plasma Cell/*diagnosis/pathology/surgery ; Humans ; Immunoglobulin G/*blood ; Plasma Cells/metabolism ; Positron-Emission Tomography ; Tomography, X-Ray Computed

Adrenal Gland Neoplasms ; pathology ; surgery ; Adrenal Glands ; pathology ; surgery ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Granuloma, Plasma Cell ; pathology ; surgery ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Neoplasms, Muscle Tissue ; pathology ; surgery

Actins ; metabolism ; Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Dura Mater ; chemistry ; pathology ; Female ; Granuloma, Plasma Cell ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

The inflammatory myofibroblastic tumor (IMT), also knowns as inflammatory pseuduotumor, is a soft tissue lesion of unknown etiology. In the urogenital tract, IMT mainly affects the urinary bladder or prostate, but rarely the kidney. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, it is regarded as a neoplasm due to its high recurrence rate and metastasis. We describe a case of a 61-yr-old woman that had originally been misdiagnosed as renal cell carcinoma, which was pathologically revealed to be an IMT.
Actins/metabolism ; Carcinoma, Renal Cell/diagnosis/pathology ; Diagnosis, Differential ; *Diagnostic Errors ; Female ; Granuloma, Plasma Cell/*diagnosis/pathology/surgery ; Humans ; Kidney Neoplasms/*diagnosis/pathology ; Magnetic Resonance Imaging ; Middle Aged ; Tomography, X-Ray Computed ; Vimentin/metabolism

Adult ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Carcinoma, Giant Cell ; metabolism ; pathology ; Diagnosis, Differential ; Granuloma, Plasma Cell ; metabolism ; pathology ; Histiocytosis, Sinus ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Lung Diseases ; metabolism ; pathology ; surgery ; Lung Neoplasms ; metabolism ; pathology ; Male ; Pneumonectomy ; methods ; S100 Proteins ; metabolism ; Vimentin ; metabolism

Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Granuloma, Plasma Cell ; metabolism ; pathology ; Histiocytoma, Benign Fibrous ; diagnostic imaging ; metabolism ; pathology ; surgery ; Humans ; Lung Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Middle Aged ; Neprilysin ; metabolism ; Pneumonectomy ; methods ; Radiography ; Sarcoma ; metabolism ; pathology ; Solitary Fibrous Tumors ; metabolism ; pathology ; Vimentin ; metabolism ; Xanthomatosis ; metabolism ; pathology

OBJECTIVETo investigate the clinicopathologic features and differential diagnostic methods for follicular dendritic cell sarcoma.

METHODSHistological and immunohistochemical examinations and EBER in situ hybridization were used to investigate the pathological features of 5 cases of follicular dendritic cell sarcoma, and related literature was reviewed.

RESULTSThere were 3 males and 2 females with a median age of 54 years (range, 28 - 75 years). The location of lesions included lymph node (2 cases), tonsil (1 case), stomach (1 case), and liver (1 case). The growth patterns were fascicular or whorls and/or diffuse. The neoplastic cells were spindle or ovoid in shape with indistinct border and slightly eosinophilic cytoplasm. The nuclei were round, oval or spindle in shape with small distinct nucleoli. Warthin-Finkeldey-like multinucleated giant cells were detected in two cases. Mitotic figures were found in 1-22/10 HPF. Immunohistochemical staining showed that CD21 and CD23 (3 of 5), CD35 (4 of 5), D2-40 (4 of 4), and CXCL13 (3 of 4) were positive in neoplastic cells. EBER was detected in one of five cases by in situ hybridization. Four cases were followed-up for 6 approximately 25 months and no recurrence or death was observed yet.

CONCLUSIONFollicular dendritic cell sarcoma is an extremely rare and should be considered as a moderately malignant tumor, and may present histological polymorphism with certain distinctive features. Immunohistochemistry is necessary in differential diagnosis to distinguish from other tumors.

Adult ; Aged ; Antibodies, Monoclonal ; metabolism ; Antibodies, Monoclonal, Murine-Derived ; Chemokine CXCL13 ; metabolism ; Dendritic Cell Sarcoma, Follicular ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Granuloma, Plasma Cell ; metabolism ; pathology ; Humans ; Liver Neoplasms ; metabolism ; pathology ; surgery ; Lymph Nodes ; metabolism ; pathology ; Male ; Membrane Glycoproteins ; metabolism ; Middle Aged ; RNA-Binding Proteins ; metabolism ; Receptors, Complement 3b ; metabolism ; Receptors, Complement 3d ; metabolism ; Receptors, IgE ; metabolism ; Ribosomal Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Tonsillar Neoplasms ; metabolism ; pathology ; surgery