Hepatic inflammatory pseudotumor associated with xanthogranulomatous cholangitis mimicking cholangiocarcinoma

Intern Med. 2015;54(7):771-5. doi: 10.2169/internalmedicine.54.2623. Epub 2015 Apr 1.

Abstract

Inflammatory pseudotumor (IPT) is a rare benign condition often misdiagnosed as malignancy. An 80-year-old man was referred to our clinic for an asymptomatic hepatic mass detected on plain abdominal CT. Abdominal ultrasonography identified the lesion as a poorly defined hypoechoic mass. Although a liver biopsy did not provide any evidence of malignancy, imaging modalities suggested a diagnosis of cholangiocarcinoma. The patient underwent left lobectomy, and the pathological findings were consistent with the features of xanthogranulomatous cholangitis. This case is the first report of hepatic IPT originating from xanthogranulomatous cholangitis without symptoms and illustrates the importance of obtaining a preoperative diagnosis in order to avoid a misdiagnosis of malignant tumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Bile Duct Neoplasms / diagnosis
  • Bile Duct Neoplasms / pathology
  • Bile Ducts, Intrahepatic / pathology*
  • Biopsy
  • Cholangiocarcinoma / diagnosis*
  • Cholangitis / diagnosis*
  • Cholangitis / pathology
  • Diagnosis, Differential
  • Diagnostic Errors
  • Diagnostic Imaging
  • Granuloma, Plasma Cell / diagnosis*
  • Granuloma, Plasma Cell / pathology
  • Granuloma, Plasma Cell / surgery
  • Humans
  • Liver Diseases / diagnosis*
  • Liver Diseases / pathology
  • Liver Diseases / surgery
  • Male
  • Preoperative Care
  • Treatment Outcome