간의 국소 염증성 병변
Focal Inflammatory Lesions of the Liver
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
비록 영상의학적 기술의 발전으로 인해 국소 염증성 병변이 간에서 종종 발견되지만, 여전히 정확한 진단을 위해 조직학적인 검사가 필요하다. 대부분의 국소 염증성 병변은 양성종양으로서 임상적 중요성이 낮고, 원인과 병리기전도 명확히 밝혀지지 않아 치료 원칙도 여전히 논쟁으로 남아있다. 비록 간조직검사의 정확도에 대한 논란이 있더라도 조직생검을 통해 국소 염증성 병변으로 확진된 경우 내과적 치료로 완치된 점을 고려하면 적극적인 조직검사가 불필요한 외과적 절제를 막고 수술로 인한 합병증을 예방할 수 있다. 그러나 간조직검사의 합병증(조직검사 경로를 통한 암전이)의 위험을 최소화하고 재발을 막기 위해 수술적 치료를 권고하는 보고도 있다. 따라서 악성종양을 배제하려는 노력에도 불구하고 여전히 의문이 남아있을 경우에는 적극적인 수술적 치료가 고려되어야 한다.
Abstract
Focal inflammatory lesions are benign lesions of various etiology reported in numerous anatomic sites. Because of the development of imaging study, most of focal inflammatory lesions were noted incidentally without symptom and sign. Among them, eosinophilic liver disease and inflammatory pseudotumor are relatively important diseases and are associated with a variety of other disease such as parasitic infestations, bacterial and viral infection, allergic conditions, autoimmune disease, and internal malignancies. These are largely self-limiting entities and have favorable prognosis. The terminology of eosinophilic liver disease is not strictly defined and a variety of terms, including focal eosinophilic infiltration, eosinophilic abscess, and eosinophilic granuloma exist histologically. Inflammatory pseudotumor was composed of diffuse infiltration of spindle-shaped cells, myofibroblasts, and mixed inflammatory cells (plasma cells, lymphocytes, and histiocytes), microscopically. Focal inflammatory lesions are difficult to differentiate clinically from malignant tumors, because these show variable imaging findings. Thus, it is important to preoperatively distinguish these lesions from malignancy. Meticulous liver biopsy is frequently needed to make differential diagnosis from malignant tumors and to avoid unnecessary resection.
참고문헌 (35)
- Lee WJ, "Foci of eosinophil-related necrosis in the liver : imaging findings and correlation with eosinophilia", AJR Am J Roentgenol, 172, pp.1255~1261 (1999)
- Yoo SY, "Focal eosinophilic infiltration in the liver : radiologic findings and clinical course", Abdom Imaging, 28, pp.326~332 (2003)
- Lim JH, "Toxocariasis of the liver : visceral larva migrans", Abdom Imaging, 33, pp.151~156 (2008)
- 이상호, "개회충에 의한 호산구성 간농양", 대한소화기학회지, 58(4), pp.226~228 (2011), 대한소화기학회
- Jin SY, "Eosinophilic liver abscess", Korean J Hepatol, 11, pp.176~179 (2005)
- Foong A, "Eosinophil-induced chronic active hepatitis in the idiopathic hypereosinophilic syndrome", Hepatology, 13, pp.1090~1094 (1991)
- Shanti CM, "Eosinophilic abscess and eosinophilic pseudotumor presenting as bile duct masses : a report of 2 cases", Surgery, 130, pp.104~108 (2001)
- Kaplan KJ, "Eosinophilic granuloma of the liver : a characteristic lesion with relationship to visceral larva migrans", Am J Surg Pathol, 25, pp.1316~1321 (2001)
- Hong SW, "Expression of eosinophil chemotactic factors in stomach cancer", Yonsei Med J, 40, pp.131~136 (1999)
- 강혜련, "호산구성 간농양 54예의 임상양상 분석", 천식 및 알레르기, 24(2), pp.229~235 (2004), 대한천식알레르기학회
- Hyun-JungJang, "Focal Eosinophilic Necrosis of the Liver in Patients with Underlying Gastric or Colorectal Cancer:CT Differentiation from Metastasis", Korean Journal of Radiology, 3(4), pp.4~244 (2002), 대한영상의학회
- Kim YK, "MRI findings of focal eosinophilic liver diseases", AJR Am J Roentgenol, 184, pp.1541~1548 (2005)
- Kim WH, "Fluorine-18-FDG PET findings of focal eosinophilic liver disease: correlation with CT and", or MRI, laboratory, and pathologic findings, 2010, pp.35, 437~446
- 김영석, "Fluorine-18 FDG 섭취증가로 인해 PET-CT에서 간전이로 오인된 호산구성 간농양", 대한소화기학회지, 54(6), pp.349~354 (2009), 대한소화기학회
- Pack GT, "Total right hepatic lobectomy; report of a case", Ann Surg, 138, pp.253~258 (1953)
- Jin SY, "Inflammatory pseudotumor of the liver", Korean J Hepatol, 11, pp.90~93 (2005)
- Sari A, "Inflammatory pseudotumor of the liver diagnosed by needle biopsy : report of three cases(one with neuroendocrine tumor of the rectum and lung)", Turk J Gastroenterol, 21, pp.308~312 (2010)
- Dehner LP, "Inflammatory myofibroblastic tumor : the continued definition of one type of so-called inflammatory pseudotumor", Am J Surg Pathol, 28, pp.1652~1654 (2004)
- 박경식, "간의 염증성 거짓종양 - 15 사례 임상 분석 -", Clinical and Molecular Hepatology, 12(3), pp.429~438 (2006), 대한간학회
- Lee SL, "Hepatic inflammatory pseudotumor: case report, review of the literature, and a proposal for morphologic classification", Pediatr Surg Int, 17, pp.555~559 (2001)
- Someren A, ""Inflammatory pseudotumor"of liver with occlusive phlebitis : report of a case in a child and review of the literature", Am J Clin Pathol, 69, pp.176~181 (1978)
- Horiuchi R, "Inflammatory pseudotumor of the liver : clinicopathologic study and review of the literature", Cancer, 65, pp.1583~1590 (1990)
- Lupovitch A, "Inflammatory pseudotumor of the liver : report of the fine needle aspiration cytologic findings in a case initially misdiagnosed as malignant", Acta Cytol, 33, pp.259~262 (1989)
- Jeong JY, "Hepatic inflammatory pseudotumor misinterpreted as hepatocellular carcinoma", Clin Mol Hepatol, 18, pp.239~244 (2012)
- Zen Y, "IgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis?", Am J Surg Pathol, 28, pp.1193~1203 (2004)
- Faraj W, "Inflammatory pseudo-tumor of the liver : a rare pathological entity", World J Surg Oncol, 9, pp.5~ (2011)
- Su LD, "Inflammatory myofibroblastic tumor : cytogenetic evidence supporting clonal origin", Mod Pathol, 11, pp.364~368 (1998)
- Fukuya T, "Diagnosis of inflammatory pseudotumor of the liver : value of CT", AJR Am J Roentgenol, 163, pp.1087~1091 (1994)
- Choi M., "inflmmatory lesions of the liver", Clin Mol Hepatol, 18(1), pp.18~22 (2012)
- Chong A, "Inflammatory pseudotumours resembling multiple hepatic metastases and their complete regression, as revealed by 18F-FDG PET", CT, 2009, pp.36, 1199~1200
- Schwarz RE, ""Pseudo-pseudotumor"of the liver : adenocarcinoma presenting as an inflammatory pseudotumor", Dig Dis Sci, 39, pp.2679~2684 (1994)
- Han JK, "Inflammatory pseudotumor of the liver", Korean J Hepatol, 12, pp.579~582 (2006)
- Hussong JW, "Comparison of DNA ploidy, histologic, and immunohistochemical findings with clinical outcome in inflammatory myofibroblastic tumors", Mod Pathol, 12, pp.279~286 (1999)
- Kawaguchi T, "Inflammatory pseudotumor of the liver and spleen diagnosed by percutaneous needle biopsy", World J Gastroenterol, 18, pp.90~95 (2012)
- Ntinas A, "Inflammatory pseudotumor of the liver : a case report and review of the literature", J Med Case Rep, 5, pp.196~ (2011)