Abstract
A 49-year-old woman complained of general malaise and anorexia for the previous 4 months, a loss of body weight of 6 kg over 3 months, and the appearance of leg edema during the previous 1 month. Blood tests conducted by her local physician indicated hepatic disorder, and she was thus referred to our department. She had an AST level of 800 IU/L and ALT level of 641 IU/L, thus confirming hepatic disorder. Tumor markers were elevated, with an alpha-fetoprotein level of 103 ng/ml and a calcium 19-9 level of 65 U/ml.
Abdominal ultrasonography showed an irregular shaped, iso-hypo echoic mass with an unclear tumor margin in left lobe of the liver. The results of computed tomography (CT) and magnetic resonance imaging (MRI) showed enhancement from the hepatic portal region to the center of the liver, which suggested the presence of a tumor. In addition, ascites and lymph node enlargement around the celiac artery were noted.
Blood examination and symptoms improved while the patient was under observation, and the ascites resolved within 2 months. A liver biopsy led to the histological diagnosis of a hepatic inflammatory pseudotumor. This case is presented as a rare case of hepatic inflammatory pseudotumor involving severe hepatic dysfunction, ascites retention, and swelling of celiac lymph nodes.
