K. Nagano et al., CASE REPORT: Reactive lymphoid hyperplasia of liver coexisting with chronic thyroiditis: Radiographical characteristics of the disorder, J GASTR HEP, 14(2), 1999, pp. 163-167
Background: Reactive lymphoid hyperplasia of the liver is an extremely rare
entity, with six cases reported so far.
Methods:We encountered a 47-year-old Japanese female with reactive lymphoid
hyperplasia of the liver, which coexisted with chronic thyroiditis. The le
sion was discovered incidentally as a hypo-echoic mass with a hyper-echoic
rim at a routine ultrasonography examination. It increased from 12 to 17 mm
diameter in 6 months. Radiological studies, such as contrast-enhanced comp
uterized tomography (CT) and angiography demonstrated a hypervascular lesio
n.
Results: It was consequently diagnosed as a neoplasm with malignant potenti
ality and she underwent partial hepatectomy. The lesion was composed of sma
ll mature lymphocytes which formed prominent lymphoid follicles with germin
al centres, scattered plasma cells and stromal fibrosis. Immunohistochemica
l study revealed polyclonal origins of the involved lymphocytes. DNA analys
is for the immunoglobulin heavy gene and the T cell receptor beta gene usin
g Southern blot hybridization showed no monoclonality. The following featur
es have characterized the images in past cases, as well as ours: hypo-echoi
c mass, occasionally with a rim, in ultrasonography and hypervascularity, s
hown by angiography and enhanced CT.