Case Report

Pseudolymphoma of the liver: a case report


Marina F. Pezzini, Nelson D. Suarez, Dvora Joveleviths, Carlos Thadeu S. Cerski

Gastroenterology and Hepatology Sciences, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil


Abstract


Pseudolymphoma or reactive lymphoid hyperplasia is a rare benign tumor characterized by the proliferation of lymphocytes forming follicles with an active germinal center, which is generally difficult to diagnose and it is easily confused in imaging studies, whose findings may suggest malignancy. A 64-year-old woman with a history of nonspecific gastric symptoms was found to have micronodules and a 1.6-cm cyst with thin central septa in the subcapsular region of segment VII on abdominal ultrasound. The tumor markers associated with liver malignancy were negative. Hepatitis C virus infection after blood transfusion was treated with Interferon-alpha and Ribavirin and cured after treatment. A magnetic resonance imaging of the abdomen, describing a probable primary neoplastic lesion, likely hepatocellular carcinoma, LI-RADS 4 in segment III and LI-RADS 3 in segment VII, was done. Partial hepatectomy of the posterior segment was performed. The pathological diagnosis was pseudolymphoma of the liver. Pseudolymphoma is a very rare condition in which it is important to evaluate the characteristics of the lesion on imaging in order to differentiate it from a malignant lesion and not opt for unnecessary treatments.

Keywords: hepatectomy, hepatocellular carcinoma, pseudolymphoma, reactive lymphoid hyperplasia