Abstract
A 76-year-old man complaining of left chest pain and fever was referred to our hospital for a hepatic tumor in the left lateral segment detected by computed tomography at a local hospital. Except for slight increase in serum concentrations of C-reactive protein, no abnormal findings including tumor markers such as carcinoembryonic antigen and carbohydrate antigen 19-9 were noted. Abdominal ultrasound revealed a hypoechoic lesion, 5 cm in diameter, with a strong echo with acoustic shadow in the left lateral segment. Abdominal computed tomography demonstrated a low-density lesion with peripheral enhancement. Based on these findings, the tumor was suspected to be an intrahepatic cholangiocarcinoma or an abscess associated with hepatolithiasis, and a left hepatectomy was performed. The findings obtained from resected specimens were a whitish solid mass containing bilirubin stones. Histologic examination showed inflammatory cell infiltration and proliferation of collagen fibers around the bile duct and no evidence of malignancy. The patient was diagnosed as laving a hepatic inflammatory pseudotumor with hepatolithiasis.
